Here at Savista, we help healthcare organizations navigate key challenges in clinical care and revenue cycle performance. This role focuses on resolving complex healthcare insurance denials, supporting timely reimbursement, and maintaining compliance with applicable policies and regulations.
The Accounts Receivable Specialist is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables and working through complex denials.
Responsibilities include:
- Verifying or obtaining patient eligibility and/or authorization for healthcare services
- Updating patient demographics and insurance information in systems
- Researching and appropriately statusing unpaid or denied claims
- Monitoring claims for missing information, authorization, and control numbers
- Reviewing EOBs for payments or adjustments to resolve claims
- Contacting payers by phone or written correspondence to secure payment
- Accessing client systems for payment and claim information
- Following prioritization, timely filing, and notation protocols
- Securing medical documentation as requested by third-party payers
- Researching provider billing manuals to obtain billing guidelines and requirements
- Writing appeal letters for technical appeals
- Verifying underpayments by researching contracts and claims data
- Preparing claims for clinical audit processing when denials involve authorization, coding, level of care, or length of stay
- Supporting compliance with HIPAA, FDCPA, FCRA, and other applicable laws
Requirements & Qualifications
Required qualifications:
- High school diploma or GED
- At least 3 years of experience in healthcare insurance accounts receivable follow-up
- Experience working with or for a hospital or hospital system, or directly with government or commercial insurance payers
- Experience identifying billing errors and resubmitting claims
- Experience following up on payment errors, low reimbursement, and denials
- Experience reviewing EOB and 1500 forms to conduct A/R activities
- Knowledge of accounts receivable practices, medical business office procedures, coordination of benefits, denial overturns, and third-party payer billing and reimbursement procedures
- At least 3 years of experience with accounts receivable software
- Experience navigating payer sites for appeals, reconsiderations, benefits verification, and online claims follow-up with Medicare and Medicaid
- Proficiency with Internet Explorer and Microsoft Office, including Excel
- Strong communication and documentation skills
- Ability to work effectively with cross-functional teams and meet performance objectives
- Productivity requirement of 55 claims per day / 275 claims per week
Preferred skills:
- Epic experience
- Experience with both hospital facility and physician pro-fee A/R
Location
Georgia, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago