Revenue Recovery Specialist, Clinical Denials

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🔥 4 minutes ago

🏈 Alabama, Arizona, +17 more states – Remote

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⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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👻 Ghost score 10%

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Logo of Knowtion Health

Knowtion Health

501 - 1000 employees

Founded 2008

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Private Equity Round on 2020-09

Consulting • Insurance • Logistics

Knowtion Health is a company that assists hospitals in handling denied and complex claims, recovering low balance accounts, and providing defense against payer audits. By leveraging advanced technology and a team of experts, Knowtion Health aims to maximize revenue and improve patient experiences. Their services include addressing clinical denials and managing various challenging payer classes, positioning them as a strong advocate for their clients in the healthcare sector.

📋 Description

• Use the Artiva workflow management system to follow up on patient bills and claims and recover revenue from responsible business entities • Analyze information to identify the root cause of denied or unpaid claims and determine next steps • Pursue and obtain information needed to overturn claim denials, including patient and responsible-party information, medical necessity, employer information, and accident information • Ensure timely filing guidelines are met for maximum reimbursement • Escalate complex, complicated, or challenging accounts to management • Identify and discuss root-cause issues with management • Communicate professionally with payers and patients daily • Draft appeals with supporting documentation • Maintain accurate account notes and records

🎯 Requirements

• Minimum 1 year of experience drafting and submitting appeals with supporting documentation to overturn claim denials • High level of professionalism • Adherence to all debt collection rules and regulations • Adherence to HIPAA requirements • Moderate computer proficiency, including working knowledge of MS Excel, Word, and Outlook • Organization and documentation skills to ensure timely follow-up and accurate record keeping • Mathematical ability to calculate rates using addition, subtraction, multiplication, and division • Familiarity with CPT and ICD coding preferred • Ability to multi-task and prioritize work • Proficient use of web-based client and payer portals and notation databases • Valid government-issued photo ID required during screening and/or interviews • Dedicated, distraction-free work space at home

🏖️ Benefits

• 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 arrangement • Dedicated, distraction-free work space at home

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