应收账款专员2
Accounts Receivable Specialist 2
在Savista，我们帮助客户应对医疗行业最大的挑战：提供高质量的临床护理，提升患者体验，并实现最佳财务成果。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）。
核心职责与任务
- 通过保险公司网站、客户资质系统或与保险公司/医疗服务提供者电话联系，验证/获取资格和/或授权
- 在适当系统中更新患者人口统计信息/保险信息
- 调查未支付或被拒的索赔
- 监控缺少信息、授权和控制编号（ICN/DCN）的索赔
- 调查费用账单（EOB）以解决索赔的付款或调整
- 通过电话或书面通讯联系保险公司，确保索赔付款；提交重新考虑和上诉
- 访问客户系统获取付款、患者、索赔和数据信息
- 遵循适当的系统中的优先级指南、及时提交截止日期和备注协议
- 获取第三方保险公司所需的医疗记录
- 按照保险收集指南和公司政策与程序，维护和尊重患者信息的机密性
- 执行其他相关职责
最低要求与能力
- 2-3年医疗催收、拒付和上诉经验
- 具有包括但不限于以下拒付经验：DRG降级、护理级别、编码、医疗必要性
- 熟悉ICD-10、CPT、HCPCS和NCCI
- 熟悉第三方计费指南
- 熟悉计费索赔表（UB04/1500）
- 熟悉保险公司合同——商业和政府类
- 熟练使用Microsoft Word和Excel
- 熟悉健康信息系统（如EMR、索赔检查工具、患者会计系统等）
优选要求与能力
- 熟悉以下一种或多种患者会计系统——EPIC、Cerner、STAR、Meditech、CPSI、Invision、PBAR、All Scripts或Paragon
- 熟悉DDE Medicare索赔系统
- 熟悉政府法规和规定
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).
Essential Duties & Responsibilities
- Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers
- Update patientdemographics/insuranceinformation in appropriate systems -
- Research/ Status unpaid or denied claims
- Monitor claims for missing information, authorization and control numbers (ICN//DCN)
- Research EOBs for payments or adjustments to resolve claim
- Contacts payers via phone or written correspondence to secure payment of claims; reconsideration and appeal submission.
- Access client systems for payment, patient, claim and data info
- Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
- Secure needed medical documentation required or requested by third party insurance carriers
- Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
- Perform other related duties as required
Minimum Requirements & Competencies
- 2-3 years of medical collections, denials and appeals experience
- Experience with all but not limited to the following denials- DRG downgrades, level of care, coding, medical necessity
- Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
- Intermediate knowledge of third-party billing guidelines
- Intermediate knowledge of billing claim forms (UB04/1500)
- Intermediate knowledge of payor contracts- commercial and government
- Intermediate Working Knowledge of Microsoft Word and Excel
- Intermediate knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
Preferred Requirements & Competencies
- Intermediate knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
- Intermediate of DDE Medicare claim system
- Intermediate Knowledge of government rules and regulations
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 $19.00 to $22.00 per 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