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Revenue Recovery Analyst
2 months ago
Position Overview:
The Revenue Recovery Analyst will play a crucial role in assisting organizations with the recovery of outstanding revenues and identifying responsible parties, often overseeing multiple client accounts simultaneously. The ideal candidate will demonstrate exceptional accounting and organizational capabilities to effectively manage incoming payments, outgoing claims, database updates, denial reviews, and other essential daily tasks.
Key Responsibilities:
- Conduct follow-ups on all claims that are over 30 days old using the Electronic Health Record (EHR) systems for each client, including platforms such as RXNT, Therapy Notes, Share Note, Office Ally, Availity, and Novita Sphere.
- Ensure that all claims are processed and paid accurately within a 60-day timeframe from the date of service.
- Review and submit precise billing information, Electronic Remittance Advices (ERAs), and related documentation.
- Verify accuracy in charge entries.
- Examine all Explanation of Benefits (EOBs) and ERAs sent to the Denial team for necessary adjustments, such as incorrect payment rates or service location modifiers.
- Submit CMS 1500 forms to secondary and tertiary payers within 15 days of receiving denials from primary insurance providers.
- Utilize online healthcare databases and other resources for verification and claim status updates.
- Maintain strict confidentiality and comply with all HIPAA regulations and guidelines.
- Provide weekly updates to management on completed claims activities and outstanding items, including action plans for resolution.
- Manage phone communications and take messages as required.
- Engage with various providers through email, phone, or fax for communication purposes.
- Submit prior authorization requests for providers when necessary.
- Perform additional duties as assigned by management.
- A minimum of 2 years of proven experience in claims or denial management.
- Knowledge of relevant laws and best practices regarding customer data and privacy.
- Strong numerical aptitude and comfort with financial data processing.
- Proficient in MS Office, particularly Excel, and EHR software.
- Fluent in English.
- Results-oriented with a patient demeanor.
- High attention to detail and reliability.
- Ability to multitask and manage billing for various agencies.
- A high school diploma or equivalent experience is required.
Preferred Qualifications:
Familiarity with EHR programs is advantageous.
