Payment Variance Specialist II

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).

The Payment Variance Specialist II preforms research, analysis, and resolution of payment variances for the purpose of improving revenue and cash performance. This role focuses on optimizing payer reimbursements to create effective and efficient A/R management.

Duties & Responsibilities

• Reviews and resolve credit balances through credit transfers, account corrections and refund request form completion for manual refund check requests.
• Identify 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
• Review refund and overpayment requests from insurance payers to determine if an overpayment has occurred
• Post debits for approved refunds
• Research returned checks and collaborates with A/P for reporting to unclaimed property
• Resolve department credit balance inquiries for transfers and refund check requests
• Work collaboratively and build positive business relationships with clinical areas and the payer community
• Develop 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.
• Review payments received from insurance payers to ensure adherence to contracted fee schedules.
• Identifies underpayment trends and determines root causes for discrepancies and provide feedback to management
• Utilize electronic medical record/billing system Pricing Module and Contract Manager to monitor and evaluate billing and collection issues, providing detailed data and recommendations to management
• Develop expertise with payer specialty-specific payment policies, by using the payer assigned websites
• Interacts with insurance payers regarding claim payment issues

Qualifications & Competencies

• BA/BS in accounting, business, finance or an equivalent combination of training and experience
• 5 years+ in health care/managed care environment, preferably in a large physician practice
• Intermediary knowledge of physician reimbursement and managed care claim payment issues
• Excellent verbal and written communication skills and ability to effectively communicate with various levels of management in a multi-disciplinary environment.
• Understanding of electronic medical record / billing system Pricing Module and fee schedules
• Strong analytical skills with attention to detail
• Advanced level with Excel and financial analysis related to physician reimbursement.
• Ability to do math calculations, input data into the computer, and analyze data as requested.

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 $18.00 to $21.00. 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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