Revenue Recovery Specialist
About The Position
As the SME, implement best-practice processes with practice teams. Train and retrain on these processes. Research appeals and resolve claim rejections, underpayments, and denials with payers. Process appeals by gathering information and resubmitting claims. Communicate payment or denial trends that impact revenue to leadership. Identify trends of denials and claims reprocessing by practice. Recommend solutions to simplify the claims process. Work one-on-one with teams with the highest denial rates to improve their processes. Resolve problems by clarifying issues, researching potential solutions, implementing changes to maximize timely and complete reimbursement, and escalating unresolved issues.
Requirements
- Associate's Degree or equivalent experience
- 1-3 years of healthcare insurance claims experience
Nice To Haves
- Bachelor's Degree
- 3-5 years of dental claims experience
Responsibilities
- Implement best-practice processes with practice teams.
- Train and retrain on these processes.
- Research appeals and resolve claim rejections, underpayments, and denials with payers.
- Process appeals by gathering information and resubmitting claims.
- Communicate payment or denial trends that impact revenue to leadership.
- Identify trends of denials and claims reprocessing by practice.
- Recommend solutions to simplify the claims process.
- Work one-on-one with teams with the highest denial rates to improve their processes.
- Resolve problems by clarifying issues, researching potential solutions, implementing changes to maximize timely and complete reimbursement, and escalating unresolved issues.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Career Level
Mid Level
Education Level
Associate degree
