Revenue Recovery Specialist II

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🕒 Setembro 28

🏈 Alabama, Arizona, +17 estados a mais – Remoto

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⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🦅 Patrocina Visto H1B

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👻 Score fantasma 10%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Knowtion Health

Knowtion Health

501 - 1000 funcionários

Fundada em 2008

💼 Consultoria

🛡️ Seguros

📦 Logística

💰 Private Equity Round em 2020-09

Consulting • Insurance • Logistics

A Knowtion Health é uma empresa que auxilia hospitais na gestão de reivindicações negadas e complexas, recuperação de contas de baixo saldo, e defesa contra auditorias de pagadores. Ao utilizar tecnologia avançada e uma equipe de especialistas, a Knowtion Health visa maximizar a receita e melhorar a experiência dos pacientes. Seus serviços incluem o tratamento de negações clínicas e a gestão de várias classes desafiadoras de pagadores, posicionando-se como um forte defensor para seus clientes no setor de saúde.

Descrição

• Analyze denied claims to determine underlying reasons for denial • Conduct necessary follow-up actions, including preparing and submitting appeals with comprehensive documentation and justification • Communicate with payors regarding unpaid or underpaid claims • Resolve account denials and ensure timely, accurate recovery of outstanding claims • Maintain accurate records of claim activities, appeals, follow-ups, and resolutions in Artiva and client systems • Ensure compliance with regulations and guidelines governing claims processing and revenue recovery • Meet timely filing guidelines to maximize reimbursement • Identify recurring trends, issues, and process improvement opportunities • Communicate insights and actionable recommendations to management • Generate revenue through professional billing practices and proper, ethical collection efforts • Resolve outstanding hospital bills on behalf of patients without collecting money directly from patients

🎯 Requisitos

• Minimum of 3 years’ experience working for a hospital, a payer, or other relevant revenue cycle area • Preferred experience in healthcare insurance billing and/or hospital follow-up • Preferred experience in medical coding, claim adjudication, patient accounting, payer adjusting, and filing and/or settlement of motor vehicle or workers’ compensation accident claims • Expertise in medical terminology and coding, including ICD, CPT, HCPCS, modifiers, procedures, bill types, diagnosis, and revenue codes • Advanced critical thinking skills • Ability to define problems, collect data, establish facts, and draw valid conclusions • Ability to interpret regulations for Commercial Insurance, CMS, MVA, and Workers’ Compensation • Valid government-issued photo ID required during screening and/or interviews • Applicants prioritized from AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, and WV

🏖️ Benefícios

• Medical insurance • Dental insurance • Vision insurance • Life insurance • Short-term disability • Long-term disability • Bonus opportunities • Paid holidays • 401(k) • Generous PTO policy • Remote work • Dedicated, distraction-free workspace at home

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