Overview
This full-time, non-exempt position is for a Revenue Recovery Specialist I in Patient Accounting. The role is remote but requires the employee to be based in New Mexico. The work shift is during the day.
Responsibilities
- Analyze and validate claims payments against payer contract terms to ensure compliance.
- Identify payer-specific trends in the payment variance work queue and report significant or recurring issues to senior revenue recovery staff.
- Assist with validation reports and recommend configuration changes as needed.
- Maintain and apply detailed knowledge of complex hospital-specific reimbursement methodologies.
- Serve as a resource for hospital follow-up and denial teams regarding reimbursement questions.
- Demonstrate strong analytical, problem-solving, investigative, and research skills during contract and fee schedule configuration and validation.
- Report payer compliance issues to the Revenue Recovery Supervisor.
- Perform other related tasks and projects as assigned.
Qualifications
- One to two years of experience in hospital or physician medical claims processing, insurance billing, or insurance collections.
- Knowledge of third-party reimbursement and contracts.
- Detail-oriented with a thorough understanding of the insurance claim lifecycle, including the ability to interpret payer 835 data.
- Strong analytical and interpersonal skills with the ability to collaborate across revenue cycle departments.
- Organizational skills and the ability to analyze reports and interpret various reimbursement models.
Compensation & Benefits
- Pay range: $17.46 to $25.96 per hour.
- Comprehensive benefits package including medical, dental, vision, short-term and long-term disability, group term life insurance, and optional voluntary benefits.
- Employee wellness program offering opportunities to earn rewards through participation in wellness activities such as challenges, webinars, and preventive screenings.
Location
Remote position based in New Mexico, with a remote office located in Santa Fe, NM 87501.