Savista

Medical Billing and Coding

• 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.
• 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; 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 strict patient and provider confidentiality in compliance with all HIPAA Guidelines.
• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
• 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.

Coding Specialist II – Orthopedics Profee

• Review clinical documentation to assign and sequence diagnostic and procedural codes for Facility Inpatient records
• Validate MS-DRG calculations to accurately capture the diagnoses and procedures
• Perform documentation review and assessment for accurate abstracting of clinical data
• Maintain strict patient and provider confidentiality in compliance with HIPPA
• Participate in client and staff meetings, trainings, and conference calls as requested and/or required.

Inpatient Coder

Accounts Receivable

• Reviews refund/overpayment requests from insurance payers to determine if an overpayment has occurred.
• Reviews and resolve credit balances through credit transfers, account corrections and refund request form completion for manual refund check requests.
• Identifies root causes and trends contributing to patient and insurance credit balances and works collaboratively with all areas of the revenue cycle to improve efficiency and eliminate these issues.
• Posts debits for approved refunds.
• Researches returned checks and collaborates with A/P for reporting to unclaimed property.
• Resolves Department credit balance inquiries for transfers and refund check requests.
• Ability to work collaboratively and build positive business relationships with clinical areas and the payer community.
• Understanding of electronic medical record / billing system Pricing Module and fee schedules.
• Develops expertise with payer specialty-specific payment policies, by using the payer assigned websites.
• 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.

AR Refund Specialist

• This position is responsible for the day to day supervision of a team of staff.
• The Supervisor manages his/her team’s performance at an individual level and focuses on measuring and improving the key performance metrics of productivity and quality.
• Monitor staff performance, quality and address any training or performance issues accordingly.
• Perform colleague chairsides.
• Conduct routine account activity quality audits to ensure accounts are being worked appropriately.
• Collaborate with leadership and training to build training plans required to build a best practice team.
• Provide assistance/resolution to internal business partner inquiries
• Prepare reports or logs as required.
• Review of work
• Act as a technical expert in regards to denials and payer policies, to answer questions raised by team members
• Maintain a current working knowledge of all healthcare related issues and regulations
• Responsible to report any detected trends, as well as procedural problems, to internal leadership as appropriate.
• Maintain a professional attitude
• Maintain confidentiality at all times
• Analyze and solve problems quickly and thoroughly
• Establish realistic goals and priorities concurrent with organizational objectives
• Conduct daily huddles and weekly staff meeting for continued process improvement and for staff project knowledge
• Back-fill all job opening
• Approve timecards, approving/deny colleague PTO and approving payroll

Supervisor, Accounts Receivable Specialist

General

• Conduct advanced eligibility screening to assess financial assistance eligibility and provide compassionate guidance on available programs.
• Facilitate the application process for programs such as Medicaid, Medicare, Disability, hospital charity care or unique requirements for non-traditional funding, 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.
• Perform advanced follow-up work across, ensuring applications are complete and processed efficiently.
• Identify and assist with technical medical requirements for disability programs, including setting up medical appointments, completing disability applications, submitting appeals, and following through on resolution of applications.
• Manage multiple patient cases independently, 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.
• Identify and assist with complex cases, including disability applications, setting up appointments, and submitting appeals, etc. as needed.
• Assist in training and supporting colleagues as needed, ensuring seamless onboarding and service delivery.
• Complete special projects, as assigned.

Eligibility Specialist

Bilingual

• Serve as a patient advocate, meeting with patients in-person, including bedside, to assess eligibility for financial assistance programs
• Guide patients through complex application processes for programs such as Medicaid, Medicare, Disability, and hospital charity care, ensuring timely submission of accurate documentation
• Collaborate across teams, acting as a liaison between patients, hospital staff, and government agencies to secure coverage and resolve eligibility issues
• Manage a high case load effectively, prioritizing tasks, following up on pending applications, and meeting deadlines while also adhering to productivity and quality expectations
• Communicate with clarity and empathy, explaining financial responsibilities and assistance options in ways that patients can understand
• Maintain accurate and confidential records, ensuring compliance with HIPAA and organizational policies
• Use multiple systems and tools to document, track, and report on patient information
• Support operational needs, including providing limited staffing coverage at nearby hospital locations as needed
• Complete special projects, as assigned

Eligibility Specialist, Bilingual

Recruitment

• Lead full-cycle recruitment efforts for high-volume healthcare positions and specialized roles.
• Develop and execute creative sourcing strategies to identify, attract, and engage top talent.
• Build and maintain talent pipelines through networking, strategic partnerships, professional organizations, and online sourcing channels.
• Conduct candidate screenings to assess qualifications, experience, competencies, and cultural alignment.
• Partner closely with hiring managers and business leaders to understand hiring needs and workforce planning initiatives.
• Serve as a trusted advisor throughout the hiring process, ensuring a positive and engaging experience for every candidate.
• Provide timely communication and feedback to candidates throughout the recruitment journey.
• Analyze recruiting metrics and market trends to identify opportunities for continuous improvement.
• Coordinate and participate in hiring events, job fairs, university outreach, and professional networking opportunities.
• Leverage social media and digital recruiting strategies to strengthen employer branding and attract diverse talent.
• Manage executive and hard-to-fill searches with a personalized, consultative approach.
• Collaborate with HR, Finance, Marketing, and HRIS teams to support workforce planning, recruiting technology enhancements, and process improvements.
• Ensure compliance with all applicable recruiting regulations, policies, and affirmative action requirements.

Talent Acquisition Partner

• Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy
• Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers.
• Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.
• Respond timely to emails and telephone messages as appropriate.
• Communicate issues to management, including payer, system or escalated account issues.
• Participate and attend meetings as requested, training seminars and in-services to develop job knowledge.
• Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards.
• Enhances billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
• Update patient demographics/insurance information in appropriate systems
• Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
• 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.

Billing Specialist I – Medical Billing PB

• 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.

Inpatient Coding Specialist – Facility

• Review clinical documentation to assign and sequence diagnostic and procedural codes
• Validate APC calculations
• Perform documentation review and assessment for accurate abstracting of clinical data
• Maintain strict patient and provider confidentiality in compliance with all HIPAA Guidelines
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials

Profee Coder – Neurology/Neurosurgery

• 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; 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.
• Maintain strict patient and provider confidentiality in compliance with all HIPAA Guidelines.
• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
• 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.
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.

Profee Coder – Hospitalist

• 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.
• 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’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Savista’s business practices.

Accounts Receivable Specialist II

Billing Specialist

• Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy
• Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers
• Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission
• Respond timely to emails and telephone messages as appropriate
• Communicate issues to management, including payer, system, or escalated account issues
• Participate and attend meetings as requested, training seminars and in-services to develop job knowledge
• Serve and protect the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards
• Enhance billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
• Update patient demographics/insurance information in appropriate systems
• Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
• Follow 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
• Utilize provider billing manuals to obtain billing guidelines and requirements
• Import verification and escalation of import/export files
• Special Handling billing included not limited to interim bills, overlap review, redistribution of money for correct claim creation
• Resolve and research billing Rejections

• Review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types
• 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
• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types
• 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

Pro Fee Coder – Cardiology

Customer Support

• Resolve patient healthcare accounts by negotiating payment with patients/guarantors while meeting or exceeding performance and quality objectives.
• Act as an advocate for the customer.
• Serve as a liaison between colleagues, clients and State/Government agencies.
• Complete daily account related functions in an efficient and timely manner to speed-up the patient-to-payment process.
• Research and reconcile accounts, communicate with clients, government and commercial payers and operating within multiple client systems.
• Provide customer service support and resolution of routine problems and questions regarding the revenue cycle.
• Through both inbound and outbound calls leveraging an auto-dialer, negotiate payment with patients/guarantors by reviewing prior account payment history.
• Respond to customer questions utilizing knowledge and expertise on insurance and healthcare.
• Answer incoming patient or client call/email requests and handle in a prompt, courteous and professional manner.
• 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.
• Develop and maintain knowledge of patient access services and the overall effect on the revenue cycle.
• 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.
• Review and recommend modification to procedures and workflow as necessary to ensure efficient and effective processing of transactions.
• Process patient inquiries in a manner that ensures service level agreements (SLAs) are met or exceeded.
• Support Savista’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA and other laws applicable to Savista’s business practices.