Specialist, Revenue Recovery

Specialist, Revenue Recovery

This role is focused on protecting revenue through correct Coding initiatives, improving charge capture, reducing billing delays, and strengthening Cash across the organization.

The Specialist, Revenue Recovery will work to improve Coding Education, reduce DNFB/DNFC, and identify revenue leakage before claims are billed, and will serve as the operational bridge between Clinical Operations, Patient Financial Services, Coding, CDI, and RCM Operational Leadership to ensure all billable services are accurately captured and reimbursed.

DUTIES AND RESPONSIBILITIES:

• Audit unbilled accounts to ensure all services are appropriately documented, coded, and charged, reducing preventable DNFB and DNFC days.
• Identify charge variances (Underpayments) and trends while partnering with department leaders to implement corrective action.
• Support Revenue Cycle leadership through revenue integrity reporting and analysis to proactively identify opportunities for financial improvement.
• Assist with Chargemaster validation and ensuring charge compliance with CMS, payer, and regulatory requirements.
• Intercept Coding Issues from the HB/PB team for resolution
• Assist in the decrease of DNFB and DNFC days
• Provide leadership with actionable revenue integrity reporting and analytics
• Ensure collaboration between RRT Clinical Department

KNOWLEDGE, SKILLS, AND ABILITIES:

• Strong foundational understanding of the healthcare revenue cycle, including claims submission, remittance processing, and follow-up.
• Demonstrated analytical and critical thinking skills with a high level of attention to detail.
• Excellent written and verbal communication skills, with the ability to clearly and concisely document account activity.
• Proficient with computers and technology, with an aptitude for quickly learning and mastering new software platforms.
• Prior experience specifically in denial analysis or underpayment identification.
• Familiarity with reading and interpreting payer contracts and fee schedules.
• Experience working within various payer portals and systems.

WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS:

• High School Diploma or equivalent required, Associate's or Bachelor's degree in a related field preferred.
• Minimum of 2+ years of experience in healthcare accounts receivable (AR), hospital billing, or revenue cycle resolution.
• Experience working within various payer portals and systems.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

• 100% Remote
• Reliable high-speed internet connection is required for all remote/hybrid positions.
• Must have access to stable Wi-Fi with sufficient bandwidth to support video conferencing, cloud-based tools, and other online work-related activities.
• A HIPAA-compliant work environment is required, including a secure workspace free from unauthorized access or interruptions, no use of public Wi-Fi unless connected through a secure company-provided VPN, and compliance with all applicable HIPAA privacy and security regulations.