Recovery Audit Specialist

3 days ago


Durham, North Carolina, United States REVCO SOLUTIONS INC Full time
Job Description

At Revco Solutions Inc, we are seeking a skilled Recovery Audit Specialist to join our team. The successful candidate will be responsible for recovering overpayments made to healthcare providers on claims processed by Third Party Administrators (TPA) for self-funded employers.

The ideal candidate will possess excellent communication and negotiation skills, with the ability to work collaboratively with healthcare providers to resolve disputes and collect overdue payments. Strong analytical and problem-solving skills are essential for this role, as the Recovery Audit Specialist will need to identify and investigate overpayment requests, and develop effective strategies for recovery.

Key Responsibilities:

  • Conduct thorough research and analysis to identify overpayment requests and develop effective recovery strategies.
  • Communicate with healthcare providers to resolve disputes and negotiate payment plans.
  • Utilize strong analytical and problem-solving skills to identify and resolve complex issues.
  • Provide regular reporting on the status of unpaid accounts and repayment progress.

Requirements:

  • 2+ years of experience in healthcare claims environment.
  • Expertise with CMS/Medicare and/or commercial insurance reimbursement/payment policies.
  • Excellent communication and negotiation skills.
  • Strong analytical and problem-solving skills.
  • Proficient in Microsoft Office, including Microsoft Word, Outlook, and Excel.


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