Savista

• 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.

• 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

Role Description The Cash Remittance Patient Accounts Receivable Representative (PAR) performs a variety of basic to moderately complex tasks related to posting payments, adjustments and transfers to the billing and collection system in a timely and accurate manner. - Print daily lockbox images and bank statement. - Review insurance explanation of benefits and post payments to host system. - Post payments, and ensures allowances, adjustments and write-offs are posted correctly. - Post denial reasons and forward to follow up representative for further review. - Process zero pay explanation of benefits and appropriate reasons for zero pay. - Verify electronic remittances posted accurately. - Process and post credit card payments. - Investigate unidentified cash and resolve misdirected payments. - Act cooperatively and responsibly with patients, visitors, co-workers, management and clients. - Maintain a professional attitude. - Maintain confidentiality at all times. - Adheres to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. - Adheres to all applicable laws and regulations and the company's governance/compliance program. - Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. - Assists with internal control failure remediation efforts. - Becomes knowledgeable of internal control responsibilities through training and instruction. - Responsible and accountable for internal control performance within their area of responsibility. - Participates in the internal controls self-assessment process. - Ensures concerns with internal control design or performance and process changes that impact internal control execution are communicated to management. Qualifications - 2 years experience in healthcare customer service or insurance collections field. - Strong knowledge of computer billing systems. - Ability to work well individually and in a team environment. - Able to work in a professional, corporate setting. - Experience working with customer support/client issue resolution management. - Proficiency with MS Office. - Excellent oral and written communication skills. Requirements - The salary range for this role is from $18.00 to $19.50 per hour. - 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. Company Description - 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.

• 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.

• Facilitate modifications to clinical documentation through concurrent chart review and interactions with clinicians • Ensure accurate documentation of diagnosis and procedures • Educate staff on documentation opportunities, coding and reimbursement issues • Assist team in meeting and exceeding high performing CDI program metrics

• 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 • Perform documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements • Interact with client staff and providers for data integrity, clarification, and assistance in understanding coding practices • Maintain strict patient and provider confidentiality in compliance with 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

• Review clinical documentation to assign and sequence diagnostic and procedural codes • Validate APC calculations for accurate diagnoses/procedures capture • Maintain strict patient and provider confidentiality in compliance with HIPAA Guidelines • Participate in client and staff meetings, trainings, and conference calls as requested

• Review clinical documentation to assign and sequence diagnostic and procedural codes • Validate MS-DRG calculations to accurately capture the diagnoses and procedures documented in the clinical record. • Perform documentation review and assessment for accurate abstracting of clinical data • Interact with client staff and providers as needed • Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.

• 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. • 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. • Complete assigned work functions utilizing appropriate resources. • Maintain strict patient and provider confidentiality in compliance with all HIPPA Guidelines. • Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.

• The Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for Facility Observation records to meet the needs of hospital data retrieval for billing and reimbursement. • Coder performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory compliance requirements. • Coder may interact with client staff and providers. • Select and sequence ICD-10 CM and CPT codes for designated patient types which may include but is not limited to: Acute Facility Observation for Non-Teaching Level facilities. • Review and analyze clinical records to ensure accurate CPT Assignment as well as modifiers as appropriate. • Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses and procedures. • 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.