Revenue Recovery Specialist II

Role Description

The Spec II Revenue Recovery will be responsible for researching and analyzing accounts to ensure that underpayments are identified and recovered. The Specialist will determine the appropriate action needed to recover the underpayment, complete the action, and follow up on the underpayment through recovery of the outstanding monies. Duties include identifying and recovering underpayments on patient accounts. The Specialist will develop a strong working relationship with the client team and counterparts in Contract Management and will work reports and assigned tasks as they are assigned.

• Communicate directly with payors to follow up on outstanding underpayments, file underpayment appeals with payors, resolve account variance and ensure timely and accurate recovery of underpayments.
• Identify root cause of underpayments, denials, and delayed payments to clients. Work with the client team to identify, document, and address root causes of issues in the A/R.
• Maintain a thorough understanding of applicable state and federal insurance regulations as well as payor specific requirements, taking actions on underpayments accordingly.
• Document all activity accurately with all pertinent information in the client’s host system, Ensemble IQ, or other appropriate tracking system.
• Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management.
• Operate as a strong problem solver and critical thinker to resolve underpayments.
• Meet all productivity and quality standards as established by Ensemble and Revenue Recovery leadership.

Qualifications

• One (1) to three (3) years of experience in the hospital or physician insurance industry, or elsewhere in the revenue cycle, strongly preferred.
• High school diploma or GED.

Requirements

• Excellent verbal and written communication skills.
• Professional presence.
• Exceptional customer service.
• Ability to adapt to multiple client host systems.
• Integrity and honesty.
• Internal drive to succeed.
• Experience with and ability to operate in Microsoft Office suite of programs.

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement