Insurance Recovery Specialist
4 days ago
About Compass Revenue Solutions
Compass Revenue Solutions is a reputable company dedicated to providing exceptional revenue recovery services to the insurance industry.
Job Overview
The Insurance Recovery Specialist plays a vital role in our team, responsible for recovering outstanding accounts receivable dollars from insurance payers.
Key Responsibilities
- Establish strong relationships with insurance payers to ensure timely resolution of outstanding claims.
- Analyze and understand explanations of benefits and remittances to identify potential issues.
- Maintain comprehensive knowledge of departmental guides, payer rules, templates, and platforms.
- Work closely with clients, internal operations, and portals to resolve correspondence denials.
- Identify and resolve problematic claims through thorough investigation and analysis.
- Apply specialized knowledge of contracts, regulatory guidelines, and contractual billings requirements to determine an account's ability to pay after initial denial.
- Analyze and resolve issues causing payer payment delays.
- Document root causes for claim denials, underpayments, and identify solutions.
- Identify and note duplicate billings, coordination of benefits, medical records, or clinical documents needed from payers to expedite payment.
- Communicate with AR Director and Team Lead on denial trends, including timely escalation and regular updates.
- Identify and communicate billing discrepancies to Team Lead and AR Director.
- Stay up-to-date with available payer website tools for claim and remittance functions.
- Assist with special projects utilizing excel spreadsheets and effectively communicating results.
- Communicate problems, questions, and concerns to AR Director in a timely manner.
- Maintain current knowledge of payer policy updates and internal billing policies and procedures.
- Prioritize workflow and work within established deadlines.
- Meet productivity and quality standards set by management.
- Ensure adherence to HIPAA standards regarding patients' protected health information (PHI).
- Fulfill additional requests from AR Director and/or Team Lead as required.
Requirements
To succeed in this role, you will need:
- A High School diploma or equivalent – relevant work experience may be considered in lieu of formal education.
- Proven interpersonal skills, enabling effective communication with a wide range of stakeholders, including insurance companies, office staff, facility operators, and other colleagues.
Benefits
We offer a competitive salary package, including:
- A base salary of $55,000 - $65,000 per annum, depending on experience.
- Medical, Dental, Vision, Life insurance coverage.
- An Employee Assistance Program.
- A 401(k) Match program.
- Paid-Time Off and Sick Time.
- Holiday Pay.
Work Environment
This position is open to in-office, hybrid, and remote work arrangements for the right candidate.
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