AR Specialist

14 hours ago


Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

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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