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Payment Resolution Specialist

Role overview

Qualifications

  • High School Diploma or GED
  • Strong organizational and time management skills
  • Experience managing priorities, multiple systems, and performance metrics
  • Proficient in Medicare, Managed Care, and Commercial Insurances

Responsibilities

  • Verify patient eligibility, billing, and claim information across various systems
  • Review and update patient demographics, insurance details, and coverage in Client systems
  • Track account progression and update internal systems accordingly
  • Monitor payments in Client systems for accurate invoicing

Key facts

Other skills

  • Microsoft Office
  • Organizational Skills
  • Time Management
  • Communication
  • Problem Solving

About the company

Savista logo

Savista

Outsourcing & Offshoring

We've been solving the biggest challenges in healthcare revenue cycle for over 30 years, under prominent names you would recognize. We offer consultation, audits and flexible workforce staffing solutions and recently achieved the prestigious Peer Reviewed designation through HFMA. We partner with over 330 hospitals, systems and physician practices at 770+ facilities across 49 states. The results: Reduced AR days, higher receivables, streamlined processes.... and a stronger bottom line.

Company details

Company typeLarge
IndustryOutsourcing & Offshoring
Company size1001 - 5000

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Job description

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 Summary
The Payment Resolution Specialist is responsible for ensuring accurate and timely management of account approvals and payment processing for Client programs. This role involves verifying patient eligibility, updating insurance information, and coordinating authorizations as needed to support efficient billing and collections. The specialist closely monitors account progression and payment activity, ensuring data accuracy across systems. By identifying and addressing issues proactively, they help maintain compliance, protect patient information, and support effective revenue cycle operations.

Duties & Responsibilities

  • Verify patient eligibility, billing, and claim information across various systems

  • Review and update patient demographics, insurance details, and coverage in Client systems

  • Review accounts for authorization and forward to the Clinical team for review

  • Prepare and send approval, exception, or denial reports to Clients

  • Track account progression and update internal systems accordingly

  • Follow guidelines for prioritization, timely filing, and notation protocols

  • Monitor payments in Client systems for accurate invoicing.

  • Identify and escalate payer, system, or account issues as needed.

  • Maintain confidentiality and follow guidelines on prioritization, timeliness, and documentation.

  • Participate in meetings, training, and client interactions to ensure accurate billing and collections.

  • Complete special projects as required

  • Adhere to and maintain strict confidentiality of patient information in accordance with insurance collection guidelines, HIPAA, corporate policy, and procedure, etc.

Qualifications & Competencies

  • High School Diploma or GED

  • Strong organizational and time management skills

  • Experience managing priorities, multiple systems, and performance metrics

  • Proficient in Medicare, Managed Care, and Commercial Insurances

  • Advanced MS Office skills, especially Excel

  • Excellent communication, interpersonal, and problem-solving abilities

Preferred Qualifications

  • Experience with Federal/State programs (Social Security, Medicaid, Charity Care, etc.)

  • Experience utilizing EPIC, Cerner, or Meditech systems.

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.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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