AR Specialist
2 weeks ago
Job Title: AR Specialist - Healthcare Account
About the Role:
We are seeking a skilled AR Specialist - Healthcare Account to join our team at Visaya Knowledge Process Outsourcing. As an AR Specialist - Healthcare Account, you will be responsible for verifying eligibility and authorizing medical claims, updating patient demographics and insurance information, and researching unpaid or denied claims.
Key Responsibilities:
- Verify and obtain eligibility and authorization for medical claims using payer websites, client eligibility systems, or phone calls to insurance carriers and providers.
- Update patient demographics and insurance information in relevant systems.
- Research and resolve unpaid or denied claims.
- Monitor claims for missing information, authorization, and control numbers.
- Research EOBs for payments or adjustments to resolve claims.
- Contact payers via phone or written correspondence to secure payment of claims, reconsideration, and appeal submission.
- Access client systems for payment, patient, claim, and data information.
- Follow guidelines for prioritization, timely filing deadlines, and notation protocols within relevant systems.
- Secure necessary 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.
Requirements:
- 2-3 years of medical collections, denials, and appeals experience.
- At least 6 months of EPIC tool experience.
- 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:
- Intermediate knowledge of one or more of the following patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon.
- Intermediate knowledge of DDE Medicare claim system.
- Intermediate knowledge of government rules and regulations.
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