Underpayment Recovery Specialist

Job Summary

Investigating and resolving reimbursement discrepancies, the full-time remote Underpayment Recovery Specialist will validate underpayments, prepare appeals, and collaborate with various departments to enhance payer performance during Pacific Standard business hours.

Key responsibilities

• Conduct detailed reviews of identified underpayments and prepare necessary appeals or disputes
• Collaborate with Payer Relations, Patient Financial Services, and Revenue Intelligence to support recovery efforts
• Identify patterns of underpayment and contribute to strategies for improving payer performance

Required qualifications

• 2 years of experience in healthcare revenue cycle, focusing on claims follow-up, denials, or reimbursement analysis
• Demonstrated ability to investigate claim issues and determine root causes
• Experience with payer guidelines, contracts, or reimbursement methodologies
• High School Diploma or equivalent required; Associate's degree in Healthcare Administration or related field preferred
• Strong attention to detail with the ability to manage multiple cases to resolution