Job duties:
- Understanding insurance contract terms
- Reviewing underpayments to determine if additional payment amounts can be requested
- Identifying trends in payment discrepancies amongst payers
- Auditing closed balance and write-off claims to ensure accuracy of payment to contract
- Reviewing contract terms for revenue capture and maximization per billing and coding guidelines
- Working with contract management to identify opportunities when negotiating contracts with payers
Revenue Recovery Analysts review large amounts of remittance data and analyze utilizing databases and modeling tools to identify areas of payment variance to contract or revenue optimization opportunities and take steps appeals and corrected claims to resolve and capture the contractual underpayments. Items identified are referred to the Underpayment Specialists for follow-up after identification and initial step to resolution.
Required Minimum Education:
- High school diploma or GED
Minimum Years and Type of Experience:
- 1-2 years experience in healthcare industry.
