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Revenue Recovery Specialist - 100% Remote
 

Revenue Recovery Specialist - 100% Remote (REVEN44920) Franklin, Tennessee

Salary: USD25 - USD26 per hour
Long-term contract, 100% remote

Job Description

  • Research and resolve improperly denied or underpaid claims by insurance carriers for administrative reasons.
  • Collaborating with team members, processing appeals, resolving the denial for appropriate payment, and identifying variance underpayments.
  • Identify insurance underpayments and denials for hospital patient accounts; identification of variance underpayments and denials will include zero payments, full denials, line-item denials, billing corrections, updated billing code requirements and incorrect payor system setup.
  • Identify root cause of insurance reimbursement underpayments and take appropriate actions to resolve payment variances; work efforts are to be focused on identification and recovery of high dollar insurance underpayments to increase reimbursements for the hospital.
  • Review claims billed and insurance remits to research denials and variances; claim review may include coding, billing, and discrepancies with patients’ insurance information. Collaborate with the facilities to send corrected claims and appeals. 
  • Assist, as assigned, with follow-up on customer patient accounts that are outstanding for insurance payment, including but not limited to the following processes:  verify claim payment status, rebill claim to patient’s insurance, proration to correct financial class and notate patient accounts with steps taken to resolution. 

Requirements

  • Knowledge of hospital billing and revenue cycle terminology

  • 5 years or more experience in Hospital Billing, Insurance follow-up, Denial resolution

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