Savista

Accounts Receivable

• Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers
• Update patient demographics/insurance information 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 and/or written correspondence to secure payment of claims; reconsideration and appeal submission.
• Adhere to state and federal claim and appeal guidelines.
• Access client systems for payment, patient, claim and data info
• 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
• Understand, follow, and maintain productivity and performance based role expectations
• Perform other related duties as required.

AR Specialist 2 – Complex Clinical Denials

Medical Billing and Coding

• 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.
• 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.

Coder III

Bilingual

• 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.

Bilingual Eligibility Specialist 2

• Review clinical documentation to assign and sequence diagnostic and procedural codes
• Validate APC calculations
• Perform documentation review and assessment for accurate abstracting
• Interact with client staff and providers
• Maintain strict patient and provider confidentiality in compliance with HIPPA guidelines

Urology 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.
• 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.

OBGYN 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 as necessary.
• 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 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.
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.

Profee Coder – Primary Care

• 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 as needed.
• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types including 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.
• Complete assigned work functions utilizing appropriate resources.
• 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 – Trauma

• Review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types
• 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
• Abstract clinical data from the record after documentation review
• May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices

Pediatric Coder

• 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
• 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
• 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.

ProFee Ortho Coder

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

Oncology Coder

• 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. This includes becoming familiar with Savista's Code of Ethics, attending training as required, notifying management or Savista Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

Account Receivable Specialist II

• 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
• Interact with client staff and providers

Profee Coder – OBGYN

• Medical Coders are responsible for review and submission of 64 encounters per day or 8 per hour related to evaluation & management, procedures, testing, monitoring and hospital services daily.
• Must be comfortable with discussing coding and guidelines with providers in a collaborative and professional manner.
• This position will assist with work que evaluation and update of pending encounter status and service lines.
• Will work with leadership on projects for coding as needed to assist with workflows.
• Medical coding of Cardiology evaluation and management, Non-Invasive procedures, Remote and Pacer Monitoring, Cardiac Cath and Electrophysiology billing.
• Coder will be required to be able to charge extract, correctly apply diagnosis, correctly apply modifiers, understand NCCI edits and other regulatory requirements.
• Coder will be in regular communication via email and messaging with the clinic staff to ensure compliant and appropriate coding.
• Maintains coding knowledge and billing regulations associated with CPT and ICD-10 codes, and modifiers.
• Review assigned CPT, HCPCS and ICD-10 diagnosis codes for accuracy prior to submission.
• Consults with Coding Managers on any edit discrepancies.
• Demonstrated ability to work independently with minimal supervision.
• Complete assigned work functions utilizing appropriate resources.
• Participate in client and staff meetings, trainings, and conference calls as requested and/or required.
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
• Must be able to work denials for insurance follow-up and work collaboratively with Accounts Receivable Team.