Savista

Bilingual

• Screen patients to assess financial assistance eligibility and provide compassionate guidance on available programs.
• Facilitate the application process for programs such as Medicaid, Medicare, Disability, and hospital charity care, ensuring timely submission of accurate documentation.
• Act as a liaison between patients, hospital staff, and government agencies to establish eligibility, secure funding and resolve coverage issues.
• Manage multiple patient cases, prioritizing tasks to meet deadlines and ensure effective follow-up on pending applications.
• Clearly communicate financial obligations, funding options, and program details to patients in an empathetic and professional manner.
• Maintain accurate and confidential records in compliance with HIPAA and organizational policies.
• Consistently achieve productivity and quality metrics, contributing to the organization's financial counseling objectives.
• Efficiently use multiple systems and databases to gather, track, and report on patient data.
• Complete special projects, as assigned.

Bilingual Eligibility Specialist

Medical Billing and Coding

• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee Radiology; Technical Fee or Evaluation and Management, any associated chart capturing with any patient type
• Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record
• Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected
• Complete assigned work functions utilizing appropriate resources
• May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries
• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required

Multispecialty Certified Coder

• Review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement.
• Validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals.
• Perform documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements.
• Interact with client staff and providers when necessary.
• Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record.

Oncology Plastic Surgery Coder

Auditor

• Audit patient accounts daily as assigned using Meditech expanse, Charge Capture Audit ("CCA") module, and accounts assigned by the Client to decide charge accuracy based on documentation, compliance, and system related issues.
• Review medical record for accuracy of surgery level assignment to correctly coincide with procedures performed.
• Review visits and perform charge research and edit clearing for visits identified by the Client and according to Client policy as well as documentation and compliance requirements.
• Daily review of patient accounts and assigned Epic work queues for clinical and billing issues and correcting issues before billing.
• Participate in a monthly meeting to review results of the project upon Client request; and
• Provide patient log identifying patient accounts reviewed including detailed charge discrepancies and resolution by charge code.

Revenue Integrity – Charge Capture Auditor

Consultant

• Perform ambulatory surgery, emergency room, and evaluation/management coding audits
• Analyze audit results identifying patterns, trends, and key problematic areas
• Conduct educational services to clients based on audit results

Senior Auditing Consultant

• Manage a designated client’s audit, allocating Sr. Auditing Consultants
• Create a detailed audit project plan with a schedule of all audits and exit meetings
• Initiate contingency plans when project deadlines are at risk
• Coordinate and inform all client audit project management elements
• Collaborate with Client to establish a coding audit project plan
• Train and direct, as necessary, Audit team members
• Review, explain, and discuss final audit report(s) with Client

Certified Interventional Radiology Cardiovascular Coder, Project Lead, Auditor

Accounts Receivable

• 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).
• Research EOBs for payments or adjustments to resolve claims.
• Contacts payers by phone or through written correspondence to secure payment of claims.
• Accesses 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 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.
• Supports Savista Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Savista business practices.

Accounts Receivable Specialist, Level 2

• Review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement.
• Validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals.
• Perform documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements.
• Interact with client staff and providers.

Cardiology Coder

• Assigns either ICD-10-CM and PCS codes for inpatient visits or assigns ICD-10 CM codes, professional and technical EM levels, and surgical CPT codes for physician visits at commercially reasonable production rates and at a consistent 95% or greater quality level.
• Validates either MS-DRG or APC assignments, as applicable.
• Abstracts clinical data appropriately.
• Mitigates either hospital inpatient coding-related claims scrubber edits or professional and technical coding-related claims scrubber edits.
• Tolerates short-term assignments for up to two different clients.
• Participates in client and Savista meetings and training sessions as instructed by management.
• Maintains an ongoing current working knowledge of the coding convention in play at client assignments.

Coding Specialist III

• Assigns either ICD-10-CM and PCS codes for inpatient visits or assigns ICD-10 CM codes, professional and technical EM levels, and surgical CPT codes for physician visits at commercially reasonable production rates and at a consistent 95% or greater quality level.
• Validates either MS-DRG or APC assignments, as applicable.
• Abstracts clinical data appropriately.
• Mitigates either hospital inpatient coding-related claims scrubber edits or professional and technical coding-related claims scrubber edits.
• Tolerates short-term assignments for up to two different clients.
• Participates in client and Savista meetings and training sessions as instructed by management.
• Maintains an ongoing current working knowledge of the coding convention in play at client assignments.
• Performs other related duties as required.

IP Rehab Coding Specialist

• Review clinical documentation to assign and sequence diagnostic and procedural codes
• Validate APC calculations for accurate capturing of diagnoses/procedures
• Abstract clinical data after documentation review
• Maintain strict patient and provider confidentiality

Coding Specialist II – Trauma

• Review clinical documentation to assign and sequence diagnostic and procedural codes
• Validate MSDRG and/or APC calculations accurately capturing diagnoses/procedures
• Perform documentation review and assessment for accurate abstracting of clinical data
• Interact with client staff and providers
• Participate in client and nThrive staff meetings, trainings, and conference calls as requested

Medical Coding III

Collections

• Meet or exceed performance objectives including account resolution and quality assurance goals.
• Perform routine tasks or repetitious tasks with care and attention while maintaining accurate documentation of patient/guarantor encounters.
• Identify trends and determine root cause for balance discrepancies and perform actionable steps to resolve inconsistencies.
• Answer incoming patient or client call/email requests and handle in a prompt, courteous and professional manner.
• Execute appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts.
• Develop and maintain knowledge of patient access services and the overall effect on the revenue cycle.
• Develop and maintain knowledge of commercial and government insurance plans (Medicaid and Medicare), payer networks, government resources, and medical terminology.
• Create, distribute, maintain, and file various accounting reports and /or correspondence.
• Analyze and interpret accounting documents and/or correspondence, requiring great attention to detail.
• Perform file maintenance for corrections and additions to patient records such as updating account balances, addresses, authorizations, correspondence information, statements, payment plans and account status.
• Interact with both client and internal departments to ensure proper account handling
• Interfaces with team members, management, and customers in reference to patient issues.
• Review and recommend modification to procedures and workflow as necessary to ensure efficient and effective processing of transactions.
• Processes patient inquiries in a manner that ensures service level agreements (SLAs) are met or exceeded.
• A subject matter expert that assists the team with escalated customer and client issues, coaches and trains other team members.

Support Services Specialist II – Medical Bad Debt Collections

Primary Care, Geriatrics Coder – Academic Inpatient

• Review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement.
• Validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals.
• Perform documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements.
• Interact with client staff and providers.
• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include ancillary (diagnostic)/ recurring; hospital, clinic; physician pro fee; technical fee or evaluation and management.
• Review and analyze facility records to ensure that APC assignments and/or evaluation and management codes accurately reflect the diagnoses/procedures documented in the clinical record.
• Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
• Complete assigned work functions utilizing appropriate resources.
• Act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.