Revenue Recovery Specialist

Job Summary

To support revenue generation efforts, the remote Revenue Recovery Specialist II will analyze denied claims, communicate with payors to resolve outstanding accounts, and maintain accurate records of claim activities while ensuring compliance with regulations.

Key responsibilities

• Conduct thorough analysis of denied claims and execute necessary follow-up actions, including appeals preparation and submission
• Communicate with payors to resolve unpaid or underpaid claims and ensure timely recovery of outstanding amounts
• Maintain meticulous records of all claim activities in relevant systems and identify opportunities for process improvement

Required qualifications

• Minimum of 3 years' experience in a hospital, payer, or relevant revenue cycle role
• Preferred experience in healthcare insurance billing, medical coding, and claim adjudication
• Expertise in medical terminology and coding (ICD, CPT, HCPCS, modifiers)
• Advanced critical thinking skills with the ability to analyze data and draw conclusions