Elaine Savino

• Review, examine, develop, and prepare recommended decisions for a full range of occupational illness and injury claims for employees and survivors; including claims with an exceptional degree of complexity or difficulty in terms of determining appropriate actions on a claim.
• Research, compile, and reconcile voluminous amounts of data from various sources, and conduct analysis and interpretation of the information to arrive at the appropriate recommended decision to authorize or deny compensation and/or medical benefits.
• Receive and evaluate all medical reports and supporting medical documents. Maintain oral or written contact with claimants, witnesses, employers, doctors and attorneys for obtaining information necessary to adjudicate the claims case.
• Plan and carry out all aspects of the claims review and development, resolve conflicts that arise, interpret governing regulations, and handle the most complex and controversial claims.
• Answer numerous letters, telephone calls, and other communique related to claims development and adjudication and payment of benefits.
• Determine the amount of compensation, the extent of the disability and the length of time compensation is to be paid.

• Processing and payment of Skilled Nursing, Physical/Occupational/Speech Therapy and Home Infusion Non-VA care claims. Pricing skilled nursing visits through a separate portal to process according to AN-98 payment methodology (Medicare payment methodology) that became effective 10/1/2014.
• Determine amount approved for payment using Burgess Reimbursement system on various home health claims, process and pay invoices under Purchased Care programs, within the time limits of the "Prompt Payment Act".
• Review rejected invoices due to errors and see that the invoices are resubmitted for processing. Research any checks returned/received and forwards to Fiscal Service for appropriate action.
• Recognized by the VISN 8 manager and VISN 8, Region 2 officer for great customer service relative to AN98 payments.
• Maintained good rapport with vendors, colleagues. Detailed to authorizations unit since Aug 2017 to assist in clean up. Create authorizations for patients to be seen by Non-VA providers and uploading them or faxing them to providers.

Voucher Examiner from 01/2012 to 05/2015

• Enter authorizations, determine amount approved for payment, process and pay invoicesunder Purchased Care programs, within the time limits of the "Prompt Payment Act".

• Review rejected invoices due to errors and see that the invoices are resubmitted for processing. Research any checks returned/received and forwards to Fiscal Service for appropriate action. Prioritize my time in order to pay claims accurately and manage authorizations and complete all in a timely manner. Train and assist others on my duties when required.

• Process payments for community nursing homes, adult day healthcare, personal home care and skilled nursing visits. Create dental and community nursing home authorizations and create/organize spreadsheets for social workers. Liaison between nursing homes and facility.

• Contact nursing homes for veterans that are currently in their care. Keep track of patients admissions/discharges from hospitals, and notate when/if patient expires. Fill in when needed, to assist veteran's and families with questions regarding Purchased care and payment.

Accounts Receivable Technician 07/2007- 12/2011

• Follow policies, procedures and instructions issued for actions to collect indebtedness.
• Perform aggressive and timely follow up on all third party AR accounts. Review and analyze all information from insurance companies to ensure that payment is proper before posting to open Accounts Receivable.
• Adjust accounts receivables, including liquidations, write-offs, referrals to Regional Council, contractual decreases, compromise, etc. Maintains liaisons with Billing and Utilization Review staff to ensure reasons for denial are properly reviewed. Process refunds as necessary.
• Perform reconciliation of MCCR accounts between local system, FMS electronic accounting system and national database.

Program Support Assistant/Billing 06/2005 - 07/2007

• Perform all billing functions for treatment provided to veterans with reimbursable insurance, including those in receipt of fee services.

• Research various electronic data in order to establish the most complete bill ensuring timely filing and billing of all primary, secondary and tertiary policies.