Financial Clearance Specialist 1

by twochickswithasidehustle | Jun 6, 2025 | Uncategorized

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Job Purpose

The Financial Clearance Specialist role ensures seamless and accurate processing of financial clearance procedures. Responsibilities include contacting insurance companies, physicians, and patients to ensure patient demographic and insurance information is collected, and that a financial clearance determination can be made. It will also inform patients of their rights, financial policies, and collects patient liabilities.

Duties & Responsibilities

• 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

Qualifications & Competencies

• High School Diploma or equivalent
• 3+ years’ experience with patient registration in a hospital or physician office, directly with obtaining patient demographic and financial information, handling insurance verification and obtaining authorizations
• Proficient with commercial and government insurance plans, payer networks, government resources
• Proficient with medical and insurance terminology
• Strong customer service skills, including ability to understand, interpret, evaluate, and resolve basic to complex service issues.
• Strong attention to detail and accuracy
• Excellent verbal and written communication, telephone etiquette, interviewing, and interpersonal skills to interact with peers, management, patients, client, and external agencies
• Ability to work with a variety of stakeholders
• Proficient in utilizing a variety of computer applications and software, including but not limited to Microsoft Office Suite, Internet Explorer, and other relevant programs
• Proven track record in roles that involve managing multiple critical priorities, with a focus on delivering high-quality results and meeting performance metrics

Note: 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 $20.00 to $22.00 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.

Complex Denials Specialist, Accounts Receivable

by twochickswithasidehustle | Jun 6, 2025 | Uncategorized

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Savista partners with healthcare providers to improve their financial strength by implementing integrated spend management and revenue cycle solutions that help control cost, improve margins and cash flow, increase regulatory compliance, and optimize operational efficiency.

The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables.

Essential Duties & Responsibilities

• 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; reconsideration and appeal submission.  
• 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 

Minimum Requirements & Competencies

• 2-3 years of medical collections, denials and appeals experience 
• Experience with all but not limited to the following denials- DRG downgrades, level of care, coding, medical necessity
• Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI 
• Intermediate knowledge of third party billing guidelines 
• Intermediate knowledge of billing claim forms(UB04/1500) 
• Intermediate knowledge of payor contracts- commercial and government
• Intermediate Working Knowledge of Microsoft Word and Excel 
• Intermediate knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.) 

Preferred Requirements & Competencies

• Intermediate knowledge of one or more of the following Patient accounting systems –  EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon 
• Intermediate of DDE Medicare claim system 
• Intermediate Knowledge of government rules and regulations 

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 $18.00 to $22.00. 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.

Coder II

by twochickswithasidehustle | Jun 6, 2025 | Uncategorized

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Company Overview:

Savista partners with healthcare providers to improve their financial strength by implementing integrated revenue cycle solutions that help control cost, improve margins and cash flow, increase regulatory compliance, and optimize operational efficiency.

Job Purpose:

The Coder II reviews clinical documentation to code diagnoses and surgical CPT procedures for hospital-based claims and data needs. For either professional or technical claims and data needs, the Coder II reviews clinical documentation to code diagnoses, EM level, and surgical CPT procedures. Additionally, this role also validates APC calculations, abstracts clinical data, mitigates diagnosis, EM level, and/or surgical CPT coding-related claims scrubber edits, and may interact with client staff and providers.

Essential Duties & Responsibilities:

· Assigns ICD-10-CM codes, either professional or technical EM level, and surgical CPT codes at commercially reasonable production rates and at a consistent 95% or greater quality level.

· Validates APC assignments, as applicable.

· Abstracts clinical data appropriately.

· Mitigates diagnosis, EM level, and/or surgical CPT 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.

Minimum Qualifications:

· An active AHIMA (American Health Information Association) credential or an active AAPC (American Academy of Professional Coders) credential

· One year of relevant coding experience for the specific patient type being hired and within the last six months

· Passing score of 80% on specific pre-employment tests assigned

Note: 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 – $33.00 an hour. 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.

Billing Specialist 1

by twochickswithasidehustle | Jun 6, 2025 | Uncategorized

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Essential Duties & Responsibilities: 

• 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 

Minimum Requirements & Competencies:  

• High School Diploma or GED  
• At least one year of experience in healthcare insurance billing, working with or for a hospital/hospital system, working directly with government or commercial payers.  
• Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement and denials.  
• Experiences reading and utilizing EOB, 1500 and UB-O4 Forms  
• Knowledge of CD-10, CPT, HCPCS and NCC  
• Knowledge and ability to utilize third-party billing guidelines  
• A minimum of 6 months experience of billing claim forms (UB04/1500)  
• Understanding payor contracts and the ability to read and interpret them.  
• Basic working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)  
• Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices.   
• Demonstrated ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and use company email and calendar tools.  
• Demonstrated success working both individually and in a team environment.  
• Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter.  
• Demonstrated ability to meet performance objectives.  

Preferred Requirements & Competencies:  

• Working knowledge of one or more of the following Patient accounting systems –  EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon 
• Working knowledge of DDE Medicare claim system 
• Knowledge of government rules and regulations.1 

Note: 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 $17.00 to $19.50. 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.

Accounts Receivable Specialist 1

by twochickswithasidehustle | Jun 6, 2025 | Uncategorized

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Essential Duties & Responsibilities: 

• 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 

Minimum Requirements & Competencies:  

• 1-2 years of medical collections/billing experience 

• Basic knowledge of ICD-10, CPT, HCPCS and NCCI 

• Basic knowledge of third party billing guidelines 

• Basic knowledge of billing claim forms(UB04/1500) 

• Basic knowledge of payor contracts 

• Working Knowledge of Microsoft Word and Excel 

• Basic working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.) 

Preferred Requirements & Competencies:  

• Working knowledge of one or more of the following Patient accounting systems –  EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon 

• Working knowledge of DDE Medicare claim system 

• Knowledge of government rules and regulations 

Note: 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 $17.00 to $19.00. 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.