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Revenue Recovery Specialist

Company: Crisis Preparation & Recovery
Location: Tempe
Posted on: June 19, 2022

Job Description:

A Revenue Recovery Specialist is responsible for reviewing and analyzing claim denials, working with payers to resolve denials, tracking all denials by payer and denial category, trending recurring denials, and recommending process improvement or system edits to eliminate future denials.
Knowledge and Skills:

  • Requires knowledge of healthcare billing practices including HCPCS and ICD-10
  • Knowledge of insurance guidelines, including HMO, PPO, Medicare and state Medicaid
  • Experience reading electronic claim files
  • High-level attention to detail and accuracy
  • Clear and concise communication
  • Excellent problem solving, organizational and time management skills
  • Must be able to work in a fast paced, ever-changing work environment
  • Acts ethically and honestly and applies those behaviors to daily work activities
    • Review all claims in accounts receivable and take necessary action to resolve issues
    • Investigate payor matters for any discrepancy in payments, as necessary
    • Review rejections and denials and make claims corrections in order to resubmit claims
    • Respond to all patient or insurance telephone inquiries to ensure timely reimbursement
    • Advise supervisor of any changes in claims processing, denials, or payments
    • Utilize resources to verify status of claims
    • Validate insurance payment for accuracy and compliance based on contractual terms
    • Collect and apply primary and secondary insurance payments for patient accounts
    • Send out monthly client statements
    • Update demographic and financial information in billing system, as needed
    • Document account activity in a clear and accurate manner
    • Adhere to HIPAA privacy and confidentiality regulations and guidelines
    • Other duties and tasks may be assigned as appropriate or necessary
      Education Requirements:
      • High School diploma plus 3 years billing experience #IND


Keywords: Crisis Preparation & Recovery, Tempe , Revenue Recovery Specialist, Other , Tempe, Arizona

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