Presbyterian Healthcare Services · 6 hours ago
Revenue Recovery Specialist II
Albuquerque, NM
Contract
Onsite
Mid Level
$18.33/hr - $27.25/hr
3+ years expPresbyterian Healthcare Services is a not-for-profit healthcare system committed to improving the health of patients and communities. They are seeking a skilled Revenue Recovery Specialist II to validate, analyze, and quantify payment variances, while serving as a subject matter expert on reimbursement issues.
AssociationHealth Care
Responsibilities
Primarily responsible to validate, analyze and quantify identified payer specific trends provided by Revenue Recovery Specialist I
Must report validated payer specific trends up to Revenue Recovery Supervisor for payer intervention
Will take part in reporting variances to our various payers including running reports on variances as a result of their contract load issues
Ability to lead and facilitate work going out to Revenue Recovery Specialist I
Primarily responsible to review, test and validate the contract load in contract compliance software
Will run validation reports and make recommendations on any configuration changes that need to be made
Will work with various other departments to ensure changes are made and again validate for accuracy
Maintain and apply knowledge of complex reimbursement methodologies
Must be a resource for follow up and denial teams to answer reimbursement related questions
Demonstrates excellent analytical, problem solving, investigative and research ability during the configuration of contracts and fee schedules and throughout the validation process
Performs other related tasks and projects as assigned
Qualification
Required
Three (3) to five (5) years experience in a Hospital or Physician medical claims processing, insurance billing or insurance collections environment
Must have working knowledge of reimbursement methodologies i.e. DRGs, OPPS fee schedule, Medicare APCs, multiple surgical rules etc
Must possess organizational skills, the ability to analyze reports and work within our contract compliance system
Needs to be very detail orientated and have a thorough understanding of the life cycle of an insurance claim including being able to interpret payer 835 data
Must demonstrate strong analytical skills, strong interpersonal skills, and the ability to interface with various departments within the revenue cycle
Benefits
Medical
Dental
Vision
Short-term and long-term disability
Group term life insurance
Other optional voluntary benefits
Wellness
Company
Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities they serve.
10001+ employees
H1B Sponsorship
Presbyterian Healthcare Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (86)
2023 (85)
2022 (93)
2021 (86)
2020 (76)
Funding
Current Stage
Late StageLeadership Team
Dale Maxwell
President and CEO
Ernest Sanchez
Chief Technology Officer
Recent News
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