Revenue Recovery Specialist I

Job Summary

Analyzing claims payment and ensuring payer compliance, the full-time Revenue Recovery Specialist I will work remotely to validate claims against payer contract terms, identify trends, and report issues to senior specialists.

Key responsibilities

• Manage the payment variance work queue to identify payer-specific trends and report significant issues
• Assist in validation reports and recommend configuration changes to improve reimbursement processes
• Serve as a resource for hospital follow-up and denial teams regarding reimbursement-related inquiries

Required qualifications

• One to two years of experience in hospital or physician medical claims processing, insurance billing, or collections
• Thorough understanding of the insurance claim life cycle and ability to interpret payer 835 data
• Strong analytical and interpersonal skills for effective collaboration across revenue cycle departments
• Detail-oriented with organizational skills to analyze reports and interpret reimbursement models