应收账款代表 II
Accounts Receivable Representative II
在Savista，我们帮助客户应对医疗保健领域最大的挑战：提供优质的临床护理，带来积极的患者体验，并实现最佳的财务成果。我们与医疗机构合作，解决问题并提供收入周期改进服务，助力他们的成功，支持他们的患者，并培育他们的社区，同时践行我们的价值观：奉献、真诚、尊重和卓越（CARE）。
职位概述
应收账款专员II负责确保及时收回政府或商业医疗保险公司未结清的应收款项。
职责：
- 通过搜索付款人网站或客户资格系统，或通过与保险公司或医疗提供者进行电话沟通，验证或获取患者资格和/或医疗服务授权。
- 在适当的系统中更新患者人口统计信息和/或保险信息。
- 进行研究并适当标记未支付或被拒的索赔。
- 监控索赔中缺失的信息、授权和控制编号（ICN/DCN）。
- 研究EOB以确认付款或调整，解决索赔问题。
- 通过电话或书面通信联系付款人，以获得索赔付款。
- 访问客户系统，获取已收到的付款、未结索赔和其他必要的数据以解决索赔。
- 遵循适当的系统中的优先级指南、及时提交截止日期和记录协议。
- 按第三方保险公司要求或请求获取医疗文档。
- 通过研究供应商账单手册获取账单指南和要求。
- 编写技术性和临床性申诉信件。
- 通过研究合同和索赔数据验证少付金额的准确性。
- 在授权、编码、护理级别和/或住院时长被拒的情况下，准备索赔以进行临床审计处理。
要求：
- 高中毕业文凭或同等学历。
- 至少两年在医疗保险公司应收账款跟进方面的工作经验，曾在医院或医院体系工作，直接与政府或商业保险公司打交道。
- 具有识别账单错误并重新提交索赔以及跟进付款错误、低报销和拒付的经验。
- 具有审查EOB和HCFCA表格以进行应收账款活动的经验。
- 熟悉应收账款相关流程。
查看英文原文
Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).
Job Summary
The Accounts Receivable Specialist II is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables.
Responsibilities:
- Verifies or obtains patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client eligibility systems, or by conducting phone conversations with the insurance carrier or healthcare providers.
- Updates patient demographics and/or insurance information in appropriate systems.
- Conducts research and appropriately statuses unpaid or denied claims.
- Monitors claims for missing information, authorization and control numbers (ICN//DCN).
- Researches EOBs for payments or adjustments to resolve claims.
- Contacts payers by phone or through written correspondence to secure payment of claims.
- Access client systems for information regarding received payments, open claims and other data necessary to resolve claims.
- Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.
- Secures medical documentation as required or requested by third party insurance carriers.
- Obtains billing guidelines and requirements by researching provider billing manuals.
- Writes appeal letters for technical and clinical appeals.
- Verifies accuracy of underpayments by researching contracts and claims data.
- In the event of an authorization, coding, level of care and/or length of stay denial, prepares claims for clinical audit processing.
Requirements:
- High school diploma or GED.
- At least two years of experience in healthcare insurance accounts receivable follow up, working with or for a hospital/hospital system, working directly with government or commercial insurance payers.
- Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement and denials.
- Experience reviewing EOB and HCFCA forms to conduct A/R activities.
- Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices.
- At least two years of experience with accounts receivable software.
- Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up.
- Demonstrated ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and use company email and calendar tools.
- Demonstrated success working both individually and in a team environment.
- Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter.
- Ability to work effectively with cross-functional teams to achieve goals.
- Demonstrated ability to meet performance objectives.
- Epic Physician claims experience
Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $20.00 - $24.00 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
California Job Candidate Notice
Originally posted on Himalayas