Specialist, Revenue Recovery

Specialist, Revenue Recovery

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Specialist, Revenue Recovery based in the United States.

This is a fully remote opportunity focused on maximizing healthcare revenue for hospital clients through detailed claim and payment analysis. You will investigate technical denials, identify complex contractual underpayments, and uncover revenue that may otherwise remain unrecovered. The role combines healthcare accounts receivable expertise with advanced technology and data-driven revenue cycle processes. You will work closely with coding, clinical appeals, payer contracting, and denial management specialists to resolve challenging payment issues. Your analysis will also help identify recurring trends and root causes that can prevent future revenue leakage. The position provides an opportunity to develop deep subject-matter expertise in complex revenue recovery and reimbursement challenges. It is ideal for a detail-oriented revenue cycle professional who enjoys investigation, problem-solving, and measurable financial impact.

Accountabilities:

• Review hospital client accounts identified as having potential denials or underpayments using specialized revenue cycle technology.
• Conduct detailed investigations into technical claim denials, including eligibility issues, registration errors, missing authorizations, and other administrative problems.
• Analyze explanations of benefits (EOBs) and compare actual payments with payer contract terms and modeled reimbursement amounts to identify and quantify contractual underpayments.
• Correct data issues and resubmit claims promptly to resolve technical denials and recover outstanding revenue.
• Prepare detailed documentation, supporting evidence, and justification for underpayment appeals and resolution efforts.
• Partner with clinical appeals specialists and certified coding professionals by gathering the documentation required for complex clinical and coding-related denials.
• Identify root causes and recurring trends across payers, service lines, and denial categories to highlight opportunities for process improvement.
• Maintain thorough documentation of actions, findings, communications, and account activity to support auditability and effective team collaboration.
• Contribute to performance reporting and provide actionable insights that help internal leaders and healthcare clients reduce future revenue leakage.
• Serve as a resource for complex payment issues while collaborating with payer contract specialists and denial management leadership.
• Participate in ongoing training to strengthen platform expertise and remain current with payer requirements, reimbursement practices, and denial trends.

Requirements:

• High school diploma or equivalent required; an Associate's or Bachelor's degree in a related field is preferred.
• At least 2 years of experience in healthcare accounts receivable, hospital billing, revenue cycle management, or related resolution activities.
• Prior experience specifically analyzing denials or identifying payment underpayments is strongly preferred.
• Solid understanding of the healthcare revenue cycle, including claims submission, remittance processing, payment reconciliation, and account follow-up.
• Familiarity with interpreting payer contracts, reimbursement terms, and fee schedules.
• Experience working with multiple payer portals and healthcare payment systems.
• Strong analytical and critical-thinking abilities, with exceptional attention to detail when investigating complex accounts.
• Excellent written and verbal communication skills, including the ability to document findings and account activity clearly and concisely.
• Strong computer skills and the ability to quickly learn and effectively use new software platforms and technology.
• Ability to work collaboratively with cross-functional specialists while also managing responsibilities independently.
• Reliable high-speed internet and a stable Wi-Fi connection suitable for video conferencing, cloud-based applications, and other remote work requirements.
• Ability to maintain a secure, HIPAA-compliant home workspace that protects confidential healthcare information.

Benefits:

• 100% remote work environment.
• Opportunity to develop specialized expertise in healthcare revenue recovery and complex reimbursement issues.
• Exposure to advanced revenue cycle technology and data-driven payment analysis.
• Collaborative environment with experienced revenue cycle, coding, clinical, and payer contracting professionals.
• Opportunities for ongoing training and professional development.
• Work focused on creating measurable financial impact for hospital and health system clients.
• Secure, technology-enabled remote working environment with appropriate HIPAA-compliant practices.