Revenue Recovery Specialist – Clinical Denials

This is a fully remote position, open to applicants in Alabama, +18 more states.

📋 Description

• Utilize the Artiva workflow management system to track patient bills and claims for revenue recovery from the responsible business entity.

• Depending on the specific department, the business entities may involve any or all of the following: commercial health insurance, governmental insurance, and third-party administrators.

• Analyze information to pinpoint the root cause of denied or unpaid claims and determine the appropriate next steps.

• Seek and acquire necessary information to overturn claim denials, including patient and responsible party data, medical necessity, employer details, and accident information.

• Ensure compliance with timely filing guidelines to achieve maximum reimbursement.

• Elevate complex or challenging accounts to management for effective progress tracking.

• Identify and discuss root cause issues with management.

• Prepare and submit appeals along with supporting documentation to reverse claim denials.

• The consequences of errors in judgment are significant (potential HIPAA violation penalties, lost revenue for hospital clients, and other penalties or fines).

⛳️ Requirements

• A minimum of 1 year of experience in drafting and submitting appeals with supporting documentation to overturn claims denials is required.

• A high degree of professionalism is essential.

• Compliance with all debt collection rules and regulations is mandatory.

• Adherence to HIPAA requirements is crucial.

• Moderate computer proficiency, including working knowledge of MS Excel, Word, and Outlook.

• Strong organizational and documentation skills to ensure timely follow-up and accurate record-keeping.

• Mathematical skills to perform calculations involving addition, subtraction, multiplication, and division.

• Familiarity with CPT and ICD coding is preferred.

🏝️ Benefits

• Medical

• Dental

• Vision

• Life insurance

• Short-term disability

• Long-term disability

• Bonus opportunities

• Paid holidays

• 401k

• Generous PTO policy