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Revenue Recovery Analyst
2 months ago
Position Overview:
The Revenue Recovery Analyst plays a crucial role in assisting organizations with the retrieval of outstanding revenue and pinpointing 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 assessments, and other daily tasks.
Key Responsibilities:
- Conduct follow-ups on all claims exceeding 30 days of age utilizing the EHR system for each client, including systems such as RXNT, Therapy Notes, Share Note, Office Ally, Availity, and Novita sphere.
- Ensure all claims are processed accurately and paid within 60 days of the billed service.
- Review and submit precise billing and ERAs.
- Verify accuracy in charge entries.
- Examine all EOBs and ERAs sent to the Denial team for necessary amendments (e.g., inappropriate denial, incorrect payment rates, correct place of service or modifier).
- Submit CMS 1500 forms to secondary and tertiary payers within 15 days of receiving denials from primary insurance.
- Utilize online healthcare databases and additional resources for verification and claim status inquiries.
- Maintain strict confidentiality and comply with all HIPAA guidelines and regulations.
- Provide weekly updates to management on completed claims activities and outstanding items, including an action plan for resolution.
- Manage phone communications and take messages throughout the day.
- Engage with various providers via email, phone, or fax.
- Submit prior authorization requests for providers as necessary.
- Perform additional duties as assigned by management.
- A minimum of 2 years of proven experience as a claims or denial specialist.
- Knowledge of laws and best practices regarding customer data and privacy.
- Comfortable with numerical data and financial processing.
- Strong proficiency in MS Office (especially Excel) and EHR software.
- Fluency in English.
- Results-oriented and patient.
- High attention to detail and reliability.
- Able to multitask and manage billing for various agencies.
- High school diploma or equivalent experience required.
Knowledge of EHR programs is preferred.
