Insurance Recovery Specialist

4 days ago


Peachtree City, Georgia, United States Compass Revenue Solutions Full time

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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