Exact Billing Solutions ยท 1 day ago
Revenue Recovery Specialist
Miramar, FL
Full-time
Onsite
Mid Level
$26/hr - $27/hr
3+ years expExact Billing Solutions is a revenue cycle management company specializing in healthcare services for substance use disorder, mental health, and autism care. The Revenue Recovery Specialist will monitor and analyze claim payment variances for behavioral healthcare cases, aiming to optimize revenue recovery and ensure compliance with payor agreements.
BillingConsultingHealth CareMedicalSoftware
Responsibilities
Use internal data and systems to research delinquent or underpayment accounts, identify and document them, and track and summarize payment variances to determine appropriate actions to be taken
Document appeals of payment variances and reimbursement amounts recovered
Help develop a knowledgebase and understanding of payor regulations or requirements, terms of Single Case Agreements (SCAs), third-party payor regulations, payment agreements, coverage and benefit plans, coordination of benefits, payment terms, and all other conditions affection payment
Analyze internal processes, technical system issues, and payor processing/system issues and determine/communicate corrective actions to resolve payment variances
Perform special projects to resolve recovery issues, settle with payors, and optimize revenue recovery
Qualification
Required
Previous experience in out-of-network negotiations
3+ years in business, insurance, or managed care industry settling patient accounts or a related healthcare area such as utilization management, case management, or hospital audit and reimbursement
Willingness to submit to drug and background screenings
Preferred
Bachelor's degree in Accounting, Business Administration, or other finance-related area is preferred (OR a combination of education and experience resulting in comparable knowledge and abilities)
Experience in health-related agreements involving rate and language analysis, audit and reimbursement, claims denial, and appeals preferred
Knowledge or willingness to learn fundamentals of coding CPT/HCPCS, ICD-10, and DRG is preferred
Benefits
21 paid days off (15 PTO days, increasing with tenure, plus 6 holidays)
Flexible Spending Account (FSA) and Health Savings Account (HSA) options
Medical, dental, vision, long-term disability, and life insurance
Generous 401(k) with up to 6% employer match
Company
Exact Billing Solutions
Exact Billing Solutions offers revenue cycle management to help reduce medical billing costs.
201-500 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase