Revenue Recovery Specialist

Location: Avera Health • Worker Type: Regular • Work Shift: Day Shift (United States of America) • Pay Range: $19.50 - $25.50 (actual pay dependent upon experience) Brief Overview Responsible for researching, analyzing and validating accounts to resolve denials, inappropriate payment and non payment of claims. The Specialist will identify, review and interpret third party payments, adjustments, denials, and facilitate appeals. Responsible for taking the appropriate action needed to correct the account, complete the correction or omission, and maintain documented action to follow‑up on the collection and optimization of accurate reimbursement for all appropriate payers. Responsibilities Account review and follow up on unpaid claims for resolution. Research for appropriate information and process claims with corrected claim information or appeal. Reconcile patient accounts to ensure the payment, balance or refund is correct. Collaborate with internal departments to ensure claim accuracy for timely processing. Monitor and review payer correspondence for claim processing updates, claim audits and denials, and refund requests. Serve as a resource to various departments within the Central Business Office to answer questions with regard to network discounts, reimbursement, provider networks, and government payers. Monitor & report trending of third party reimbursement issues to next level leader for revenue cycle optimization. Qualifications Must be able to work the hours specified. Must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. Preferred: 1-3 years related experience. Expectations and Standards Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. Promote Avera’s values of compassion, hospitality, and stewardship. Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. Maintain confidentiality. Work effectively in a team environment, coordinating workflow with other team members and ensuring a productive and efficient environment. Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits PTO available day 1 for eligible hires. Up to 5% employer matching contribution for retirement. Career development guided by hands‑on training and mentorship. Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call View phone number on click.appcast.io or send an email to View email address on click.appcast.io. #J-18808-Ljbffr