Revenue Recovery Analyst
1 month ago
Overview:
Planned Parenthood of Orange and San Bernardino Counties has a** full-time opportunity for a Revenue Recovery Analyst in Anaheim, CA.**
The Revenue Recovery Analyst identifies, collects, and determines root causes of underpaid claims by auditing payor performance and analyzing actual payments of payors to ensure contract compliance, which is operationally critical and sensitive in nature. The Revenue Recovery Analyst will support the RCM collection team with training and escalated claim follow-up. The Revenue Recovery Analyst performs payment variance deep dive and review activities related to the incorrect processing of claims across PPOSBC. This position will focus on the resubmission, reprocessing, and correcting of denied or rejected/exhausted insurance claims (2nd Level) as well as all high-volume facilities, top payors, and high-level, complex claim issues.
At PPOSBC, we understand the importance of a well-rounded benefits program and are dedicated to providing you with unique benefits that meet the needs of you and your family. We are proud to offer a range of plans that help protect you in the case of illness or injury including:
- A competitive benefits package including medical, dental, and vision coverage for you and eligible dependents, life insurance, and long term disability.
- Benefits coverage starts after one full month of employment
- Generous vacation, sick, and holiday benefits
- Generous 401(k) matching contributions and more
Qualifications:
**Licensure and/or Certification Requirements**:
- Coding certificate is a plus.
**Minimum Education**:
- Associate's Degree required in related field.
- Bachelor’s Degree preferred or equivalent experience in related field.
**Minimum Work Experience**:
- A minimum of 5 years of experience as a medical biller/claims follow-up specialist or collections specialist in an outpatient medical setting (non-hospital) in primary care (required), family planning, ob-gyn, and related surgeries.
- Advanced knowledge of medical terminology and common industry abbreviations, anatomy and physiology, pharmacology, and pathophysiology.
- Knowledge of payor guidelines, industry billing, and coding standards, and Medi-Cal denials reason codes.
- Computer database management (electronic practice management system). EclinicalWorks/NextGen experience preferred.
- A minimum of 5 years of experience with insurance billing, coding, and reimbursement procedures.
- A minimum of 5 years of experience with HIPAA 5010 transaction standards.
- A minimum of 5 years of experience claims follow-up/appeals and health plan Accounts Receivable management for specific payors.
**Other Requirements**:
- Ability to successfully communicate with payors, including insurance companies, health plans, and medical groups, regarding unpaid claims. Knowledge of CPT4/HCPCS and ICD10 coding and billing guidelines.
- Advanced knowledge of Medi-Cal Managed Care, Commercial Payors, Medi-Cal, FPACT, & PE.
- Advanced knowledge of health care and Medi-Cal denial reasons, denials codes and descriptions, and standard denial resolution practices.
- Ability to judgment independently as to compare actual reimbursement to expected reimbursement, reviewing managed care contract terms, claims billing and clinical information to effectively reconcile underpaid accounts and maintain documentation to support this activity.
- Expert knowledge of health care reimbursement and contracting and the use of deductive reasoning, negotiating skills, and collaborative skills to uncover and recover payment discrepancies in a complex system and complex payor environment.
- Strong verbal and written communication skills are essential.
- Ability to demonstrate mature judgment, initiative, and critical thinking.
- Strong follow-up skills and time management with internal and customer stakeholders.
- Ability to maintain confidentiality.
- Accuracy and attention to detail is essential.
- Availability to work flexible hours, including weekends.
**Agency Standard Requirements**:
- Strong commitment to quality healthcare and excellent customer service is required.
- Must thrive in a fast-paced, rigorous environment with changing priorities.
- Ability to meet deadlines and work under pressure.
- Must demonstrate high-level computer skills, including Microsoft Word, Excel, and Outlook. Electronic medical records experience may also be required.
- This position requires travel to other sites and locations; if using a personal vehicle to meet this requirement, a valid CA driver’s license and current auto insurance in compliance with the minimum requirements of CA vehicle code are required.
- Abortion patients are cared for at each of our health centers and in part through the administrative, support, and other non-clinical services provided at all PPOSBC locations and by all PPOSBC employees, and supporting these critical services is an essential job duty and fundamental responsibility of all employees.
**Res
We have other current jobs related to this field that you can find below
-
Medical Collections Specialist
3 weeks ago
Anaheim, United States Jobot Full timeRevenue Recovery Analyst at Healthcare OrganizationNationwide Healthcare Organization seeking a Revenue Recovery Analyst to join their teamAbout the Company:The company has been dedicated to assisting individuals with their healthcare needs for many years, offering a wide range of health services and collaborating with medical and non-medical partners...
-
Financial Analyst
3 weeks ago
Anaheim, United States Addison Group Full timeAddison Group, in partnership with our client in the advertising industry near Anaheim, CA, seeks a Financial Analyst to join our client's finance team. Job Site Status - Our client requires the successful candidate to be in-office 5 days a week. Culture/Environment - You will work in a fun, fast-paced, and collaborative environment. Compensation/Benefits...
-
Financial Analyst
3 weeks ago
Anaheim, United States Addison Group Full timeAddison Group, in partnership with our client in the advertising industry near Anaheim, CA, seeks a Financial Analyst to join our client's finance team. Job Site Status - Our client requires the successful candidate to be in-office 5 days a week. Culture/Environment - You will work in a fun, fast-paced, and collaborative environment. Compensation/Benefits...
-
Administrative Analyst- Fire Finance
3 months ago
Anaheim, United States City of Anaheim, CA Full time**Description**: The **Anaheim Fire & Rescue Department** is seeking an **Administrative Analyst** to join in our mission to ensure the safety and welfare of the public we serve. As a member of our Fire Finance team, you will demonstrate the values of the organization while providing a high level of customer service to internal and external...
-
Sr. Financial Analyst
2 weeks ago
Anaheim, United States Clear Path Full timeOur client is hiring a Sr. Financial Analyst to lead financial planning, analysis, and budget management processes, ensuring alignment with strategic objectives, and providing actionable insights for decision-making within the organization. You'll own the FP&A systems and process to consistently meet with leaders across the organization to play a critical...
-
Grant Accounting Analyst
3 weeks ago
Anaheim, United States Covenant House California Full time**COVENANT HOUSE CALIFORNIA**: **Job Description - **Grant Accounting Analyst - LA**: **AGENCY SUMMARY**: Since 1988, Covenant House California (CHC), affectionately known as “The Cov”, has provided housing and support services for youth (primarily ages 18-25) experiencing homelessness and human trafficking in California. Founded in Los Angeles, and...
-
Sr. Financial Analyst
4 weeks ago
Anaheim, United States The Ladders Full timeOur client is hiring a Sr. Financial Analyst to lead financial planning, analysis, and budget management processes, ensuring alignment with strategic objectives, and providing actionable insights for decision-making within the organization. You'll own the FP&A systems and process to consistently meet with leaders across the organization to play a critical...
-
Administrative Analyst- Fire Finance
1 month ago
Anaheim, United States International City Management Full timeThe Anaheim Fire & Rescue Department is seeking an Administrative Analyst to join in our mission to ensure the safety and welfare of the public we serve. As a member of our Fire Finance team, you will demonstrate the values of the organization while providing a high level of customer service to internal and external stakeholders. The Administrative Analyst...
-
Patient Account Specialist I
1 month ago
Anaheim, United States KPC GLOBAL MEDICAL CENTERS INC. Full timeJob DescriptionJob DescriptionHybrid $2,000 Sign-on BonusPatient Account Specialist I (Hospital or Healthcare Exp Req)Performs account follow up from third-party payers including traditional commercial insurance carriers, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), EPO's, International Payers, Auto Liability and other...
-
Patient Account Specialist I
1 week ago
Anaheim, United States KPC GLOBAL MEDICAL CENTERS INC. Full timeJob DescriptionJob DescriptionHybrid $2,000 Sign-on BonusPatient Account Specialist I (Hospital or Healthcare Exp Req)Performs account follow up from third-party payers including traditional commercial insurance carriers, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), EPO's, International Payers, Auto Liability and other...
-
Database Engineer
1 month ago
Anaheim, United States TEKsystems Full timeDescription:ESSENTIAL POSITION FUNCTIONS:Analyzes and defines the properties required by a database management system (DBMS) that will meet the current and future needs of the company.Analyzes the organizational structure of the company and defines the logical database structure for current and future application development.Establishes, maintains, and...
-
Patient Account Specialist I or II
3 weeks ago
Anaheim, United States KPC GLOBAL MEDICAL CENTERS INC. Full timeJob DescriptionJob DescriptionSUMMARYPerforms account follow up from third-party payers including traditional commercial insurance carriers, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), EPO's, International Payers, Auto Liability and other Liability carriers, and all other non-governmental third-party payers. Duties...
-
Lead, Material Program Management
6 days ago
Anaheim, United States Harris Geospatial Solutions Full timeL3Harris is dedicated to recruiting and developing diverse, high-performing talent who are passionate about what they do. Our employees are unified in a shared dedication to our customers’ mission and quest for professional growth. L3Harris provides an inclusive, engaging environment designed to empower employees and promote work-life success. Fundamental...
-
Lead, Material Program Management
1 week ago
Anaheim, United States Harris Geospatial Solutions Full timeL3Harris is dedicated to recruiting and developing diverse, high-performing talent who are passionate about what they do. Our employees are unified in a shared dedication to our customers’ mission and quest for professional growth. L3Harris provides an inclusive, engaging environment designed to empower employees and promote work-life success. Fundamental...
-
Lead, Material Program Management_
1 week ago
Anaheim, United States L3Harris Full timeL3Harris is dedicated to recruiting and developing diverse, high-performing talent who are passionate about what they do. Our employees are unified in a shared dedication to our customers’ mission and quest for professional growth. L3Harris provides an inclusive, engaging environment designed to empower employees and promote work-life success. Fundamental...
-
Chief Financial Officer
3 weeks ago
Anaheim, California, United States Qodoro Full timeJob Description CFO (High growth IT Consulting & Solutions firm) Primary Vertical: Financial Services HybridOffice Location options:Anaheim, CA or Portland, OR Requires: 15+ years of senior finance leadership (CFO or VP Finance) within the technology or IT consulting services industry. Demonstrated strategic leadership, FP&A skills, experience with M&A...
-
Lead, Material Program Management
1 week ago
Anaheim, United States L3Harris Full timeL3Harris is dedicated to recruiting and developing diverse, high-performing talent who are passionate about what they do. Our employees are unified in a shared dedication to our customers mission and quest for professional growth. L3Harris provides an inclusive, engaging environment designed to empower employees and promote work-life success. Fundamental to...
-
Digital Marketing Specialist
3 weeks ago
Anaheim, United States Gentle Monster Full timeThe Brand Established in 2011, Gentle Monster is among the world's fastest-growing fashion design companies today. Founded under the idea of creative disruption, Gentle Monster is known for its design and art projects which connect commercial retail with various worlds of art. Fusing fashion, commerce, and art, Gentle Monster's showrooms have been featured...
-
Digital Marketing Specialist
2 weeks ago
Anaheim, United States Gentle Monster Full timeThe Brand Established in 2011, Gentle Monster is among the world's fastest-growing fashion design companies today. Founded under the idea of creative disruption, Gentle Monster is known for its design and art projects which connect commercial retail with various worlds of art. Fusing fashion, commerce, and art, Gentle Monster's showrooms have been featured...
-
Digital Marketing Specialist
3 weeks ago
Anaheim, United States GENTLE MONSTER Full timeThe Brand Established in 2011, Gentle Monster is among the world's fastest-growing fashion design companies today. Founded under the idea of creative disruption, Gentle Monster is known for its design and art projects which connect commercial retail with various worlds of art. Fusing fashion, commerce, and art, Gentle Monster's showrooms have been featured...
