Revenue Recovery Specialist II

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

📋 Description

• Evaluate denied claims to identify the fundamental reasons for denial.

• Perform necessary follow-up actions, which include preparing and submitting appeals with thorough documentation and justification.

• Engage with payors regarding claims that are unpaid or underpaid.

• Address account denials and ensure the prompt and accurate recovery of outstanding claims.

• Maintain precise records of claim activities, appeals, follow-ups, and resolutions in Artiva and client systems.

• Ensure adherence to regulations and guidelines that govern claims processing and revenue recovery.

• Comply with timely filing guidelines to optimize reimbursement.

• Identify recurring trends, issues, and opportunities for process improvements.

• Convey insights and actionable recommendations to management.

• Generate revenue through professional billing practices and appropriate, ethical collection efforts.

• Resolve outstanding hospital bills on behalf of patients without collecting money directly from them.

⛳️ Requirements

• A minimum of 3 years of experience in a hospital, with a payer, or in another relevant revenue cycle area.

• Preferred experience in healthcare insurance billing and/or hospital follow-up.

• Preferred experience in medical coding, claim adjudication, patient accounting, payer adjusting, and filing or settling motor vehicle or workers’ compensation accident claims.

• Proficient in medical terminology and coding, including ICD, CPT, HCPCS, modifiers, procedures, bill types, diagnosis, and revenue codes.

• Advanced critical thinking abilities.

• Capability to define problems, gather data, establish facts, and draw valid conclusions.

• Ability to interpret regulations for Commercial Insurance, CMS, MVA, and Workers’ Compensation.

• A valid government-issued photo ID is required during screening and/or interviews.

• Applicants from AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, and WV will be given priority.

🏝️ Benefits

• Medical insurance

• Dental insurance

• Vision insurance

• Life insurance

• Short-term disability

• Long-term disability

• Bonus opportunities

• Paid holidays

• 401(k)

• Generous PTO policy

• Remote work

• Dedicated, distraction-free workspace at home