Savista

Consultant

• Ongoing monitoring of operations to identify any workflow improvements to streamline activities within the registry
• Ability to solve problems and make recommendations to support Registry functions
• Maintain all Cancer Registry Core functions according to CoC and State required standards
• Coordinate all Cancer Registry activities for the organization including abstracting, case-finding, follow-up, Cancer Committee and Cancer Conferences, data submission and reporting
• Assign work assignments and activities as needed and monitor completion
• Abstract all reportable cases within established reporting timeframes to meet service levels for CoC and State timeliness requirements
• Monitor conference frequency, format and attendance and provide information to the Cancer Committee in accordance with the Commission on Cancer guidelines
• Assist the Cancer Committee and/or Performance Improvement department in planning and conducting Quality Improvement and Enhancement Studies
• Assist with the preparation and distribution of the Cancer Program Annual Report, if applicable
• Prepare and maintain the Policy & Procedure Manual of the Cancer Registry on an annual basis
• Assist in the preparation of the Cancer Program Manual and update on an annual basis
• Submit data according to required timelines to the State Central Registry and CoC - National Cancer Data Base and RCRS
• Submit weekly and monthly productivity reports to manager
• Complete status reports to designated senior leadership according to established timeframes
• Participate in monthly project calls, conference calls and meetings, which may include presenting education topics and trends in oncology
• Interface with various departments to ensure that cancer-related information is available for the Cancer Registry
• Work with other Savista Interim Managers or CCRS Strategic Source Managers to establish Best Known Practices for Cancer Registry functions
• 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
• Attend educational conferences as requested
• Maintain certification and NCRA membership, as well as appropriate state association memberships

Registry Consultant, ODS-C

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

Accounts Receivable Specialist II

AR Specialist 2, Complex Clinical Denials

Insurance

• 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.
• Research 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

Refund Specialist - Insurance

Financial Planning and Analysis

• Process and verify administrative and financial components of financial clearance including validation of insurance benefits, medical necessity, routine and complex pre-certification, prior-authorization, scheduling and pre-registration, patient benefit and cost estimates, and pre-collection of out-of-pocket cost share
• Obtain pre-certifications, authorizations, and referrals for upcoming appointments
• Communicate recommended changes to schedules and care planning to ensure alignment with authorization requests and payor compliance
• Liaison between patient, insurance payors and providers to obtain prior authorization for prescheduled services
• Effectively address issues and offer information and support to both patients and physicians concerning financial clearance matters
• Process stat request prioritization
• Verify demographic information
• Apply payor changes to registration
• Verify, edit and/or remove user defined referral counts editing final status of referrals
• Edit the scheduled date within the referral, pend referrals to any pools, suppressing expiring referrals messages, accessing assigned referral work queues, defer/activate referral work queue items, use referral templates
• Apply critical thinking skills to identify and resolve problems proactively

Financial Clearance Specialist 1

Customer Support

• The Customer Service Representative resolves patient healthcare accounts by negotiating payment with patients/guarantors while meeting or exceeding performance and quality objectives.
• This position is responsible for completing daily account related functions in an efficient and timely manner to accelerate the patient-to-payment process.
• Responsibilities include inbound and outbound calls leveraging an auto-dialer to negotiate payment plans with customers by reviewing account history in Savista database and client portal as needed.
• Maintain a 96% quality score through superior customer service and accurate documentation of customer encounters.
• Execute appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts.
• Perform routine tasks or repetitious tasks with care and attention.
• Answer incoming patient or client call/email requests and handle in a prompt, courteous and professional manner.
• Other duties as assigned or requested by Supervisory or Managerial personnel, such as acting as back up in other departments.
• 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.
• This includes familiarization with Savista’s Code of Ethics, attending training as required, notifying management or Savista’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

Customer Service Rep 1 (Part Time - Medical Self Pay)

• 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, Complex Denials

Auditor

• Primary / Essential Functions: Clinical Staff Responsibilities: Performs audits of medical records to identify and/or defend charges, including: o Defense Audits o Patient Inquiry Audits o Disallowed Charges o Biller Requested Audits
• Completes analysis of records against established criteria, (e.g., InterQual, MCG, Medicare, Medicaid criteria), to determine if patient condition and/or care meets that criteria, including: o Avoidable day studies o Managed care, Medicare or Medicaid reconsiderations/appeals o Medicare or Medicaid RAC appeals or other specialized Audit Appeals (e.g. CERT, ZPIC, SMRC)
• Determine, request, and obtain appropriate supporting documentation from hospital, physicians, current medical literature and patient. Will compose appeal letters addressing and appealing both contract issues and medically related issues
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution. Enter audit findings and/or data into Client’s computer based system. Proficiently utilize multiple computer based systems to complete and document work (both Savista and client)
• Client based billing, Internal based billing, medical record and quality systems Microsoft Outlook, Word and Excel
• Function in a professional, efficient and positive manner Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• Will help identify issues or challenges in the department, and come up with solutions or ideas to improve
• Maintain confidentiality of patient information and abide by all HIPAA related guidelines
• Competencies: Puts Clients First Drives for Results Understands our Business Thinks Innovatively Values Differences Builds Teamwork Gains Trust Communicates Effectively Shows Accountability Takes Action Embraces Change Makes Quality Decisions
• Physical / Mental Demands, Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Must be able to use hands to finger, handle or feel, sit, stand, walk, lift up to 20 pounds, stoop, clean, bend, and reach with hands and arms. Must communicate clearly in English. Requires the ability to speak, read, write, see, and hear to perform essential duties of the job.
• Effective and positive human relations skills are required, including confidentiality, in order to appropriately interface with staff and clients. Must be able to perform multiple tasks and detailed work, problem solve, reason, and perform basic mathematical calculations. Equipment Used: Telephone, fax, calculator, computer, monitor, printer, hardware and software packages, computer peripheral equipment i.e. mouse and keyboard; and Microsoft software.
• Minimum Qualifications: RN/Case Management /Utilization Review/Coding or clinical certification with a BS/BA preferred otherwise equivalent years of technical experience 3 to 5 years of clinical experience or 3 to 5 years of clinical auditing experience in either case management, Medicare appeals, utilization review or denials management Knowledge of Milliman (MCG) or InterQual criteria preferred Experience in medical records review, claims processing or utilization/case management in a clinical practice or managed care organization Fundamental knowledge of Medicare/Medicaid Guidelines Proficiency in navigating the internet and multi-tasking with multiple electronic documentation systems simultaneously (toggling) Skilled with Microsoft Outlook, Word, Excel and EMR Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $28.00 to $40.00. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills. SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class. California Job Candidate Notice About Us The Savista experience is the combination of everything that’s unique about our culture, our core values, our commitment to success, but most importantly, it’s our people. Our colleagues are problem-solvers, flexible and agile trusted partners who believe in a culture based on service. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us a Certified Great Place to Work 4 years in a row! Read More Job Scam Alert It has come to our attention that there have been some bad actors using our company name to solicit personal information as part of a fraudulent hiring scam. Unfortunately, this is out of our control, but we want to make it clear that this behavior is unacceptable. All of our open roles are posted on our careers page . Should you apply for a role and be contacted by an employee of Savista, all of our interviews will be scheduled by someone with an @savistarcm.com email address and conducted over video call or in-person. We never ask you to provide personal information through other means, such as Telegram or social media platforms, as part of our interview or onboarding process. Savista does not and will not ask you to share any personally identifiable information (such as bank account details, SSN, etc) by any other means than a secure platform. We recommend you do not share any sensitive information over the phone or email. If you are offered a position, Savista does not and will not ask for payment to ship equipment. Fraudulent hiring scams often also ask for financial information and may ask for “advances.” Savista does not ask for any financial commitment at any stage of the recruitment process. We have reported and flagged these job scams when we’ve seen them. We also encourage you to contact your state attorney general’s office to report any potential scams and also recommend you contact any recruiting website and/or social media platform that may have been involved as well to notify them. Savista has no responsibility for fraudulent offers and advises job candidates to follow the guidance provided. Read More California Job Candidate Notice Privacy Policy © 2025 Workday, Inc. All rights reserved.

Clinical Auditor

• 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 or written correspondence to secure payment of claims
• Access client systems for payment, patient, claim and data info
• 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

AR Specialist 1

Manager

• Job Description Summary: This individual is responsible to provide remote management to include but not limited to: supervision, evaluation and monitoring of colleagues assigned to the project; maintaining contracted service levels for core registry functions (i.e. abstracting, case-finding and follow-up) according to CoC and state standards, timely completion of the organization’s data requests; PRQ support related to Cancer Registry; provided information when requested for the annual report and studies
• Job Description Job Purpose: This individual is responsible to provide remote management to include but not limited to: supervision, evaluation and monitoring of colleagues assigned to the project; maintaining contracted service levels for core registry functions (i.e. abstracting, case-finding and follow-up) according to CoC and state standards, timely completion of the organization’s data requests; PRQ support related to Cancer Registry; provided information when requested for the annual report and studies
• Position Objectives: Manage and support the cancer registry operations and ongoing compliance of Registry related CoC and/or NAPBC and NAPRC standards. Meet all Service Level Agreements and client’s expectations.
• Essential Duties & Responsibilities: Ongoing monitoring of operations to identify any workflow improvements to centralize, standardize and streamline activities within the cancer registry. Ability to solve problems and make recommendations to support Registry functions. Maintain all Cancer Registry Core functions according to CoC, when applicable NAPBC and/or NAPRC standards and State required standards. Coordinate all Cancer Registry activities for the organization including abstracting, case-finding, follow-up, data submission and reporting. Assign work assignments and activities to staff and monitor completion. Provide abstracting assistance as necessary to meet service levels for reporting timeliness requirements. Assist the Cancer Committee and/or Performance Improvement department in planning and conducting Quality Improvement and Enhancement Studies. Participate in site review preparations, collaboratively with Committee Chairs and Members, to include updates to the PRQ, committee meetings (agendas and minutes); required Reporting templates, monitoring of standard compliance and advisory guidance when requested. Prepare and maintain the Policy & Procedure Manual of the Cancer Registry on an annual basis. Supervise the daily workflow, colleague schedules, productivity reports and timecards. Manage all Cancer Registry staff. Complete all counseling, disciplinary action and performance evaluations for all direct report colleagues according to the timeframes established by Savista and the client. Submit data according to required timelines to the State Central Registry and CoC - National Cancer Data Base and RCRS. Provide orientation, on-the-job training and/or retraining to ensure operational efficiency. Participate in the interview process for all new on-site or remote hires. Monitor weekly productivity of Cancer Registry Staff to ensure that productivity and quality standards are maintained. For cancer registries staffed with multiple ODS-Cs, work with Savista QA Team to ensure annual quality audits are completed. Corrective action plans and re-audits are performed if colleague results are below 93%. Complete status reports to designated senior leadership according to established timeframes. Participate in monthly project calls, conference calls and meetings, which may include presenting education topics and trends in oncology. Interface with various departments to ensure that cancer-related information is available for the Cancer Registry. Supervisory Responsibility: Will manage all colleagues assigned to the client including Savista and non-Savista employees (if assigned). Internal Responsibilities: Maintains certification and NCRA membership, as well as appropriate state association memberships. Work with other Savista Interim Managers or Clinical Registry Outsource Managers to establish Best Known Practices for Cancer Registry functions. Attend educational conferences as requested. 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. This includes becoming familiar with Savista’s Code of Ethics, attending training as required, notifying management or Savista’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations. Other duties as requested.