Payment Recovery Specialist

Community Options, Inc.; Nashville (TN); Remote; Full time

Job summary

Join Community Options, Inc. as a Payment Recovery Specialist, where you'll conduct root-cause analyses and manage denials in a supportive team environment. Enjoy competitive hourly compensation, comprehensive benefits, and opportunities for professional growth. This remote position focuses on transforming behavioral health care for the community.

Benefits

Comprehensive benefits including medical and dental

Engaging wellness program

Career advancement opportunities

Work-life balance

Qualifications

• Three years of healthcare clerical experience required.
• Experience with Microsoft Office Suite required.
• High school diploma or GED required.

Responsibilities

• Conducts root-cause analysis of denials.
• Collaborates with team on appeals and follow-ups.
• Ensures accounts are paid according to contract guidelines.

Skills

Data analysis

Problem solving

Customer service

Collaboration

Education

High school diploma or GED

Associate degree (preferred)

Tools

Microsoft Office Suite

Job description

4 days ago Be among the first 25 applicants

Description

IT’S MORE THAN A JOB. IT’S A CALLING.

At Family Care Center, we are on a mission to transform lives by elevating behavioral health care. Our journey began in 2016 when two U.S. Army Veterans founded Family Care Center to help service members, Veterans and their families. We continue that tradition today, caring for people of all ages across a broad range of conditions with nearly 30 outpatient clinics in communities across Arizona, Colorado, Florida, Tennessee and Texas.

If you'd like to work for one of the nation's fastest-growing behavioral health providers, collaborating with other committed team members and making a positive impact on your community, we look forward to hearing from you.

Transforming lives is our life’s work.

• CARING & SUPPORTIVE CULTURE: We support you so you can support our patients. Our positive environment is complemented by an engaging wellness program, volunteer events, team activities and more.
• UNPARALLELED GROWTH OPPORTUNITIES: We offer clear paths for career advancement at every level, fostering your professional development and personal growth.
• BALANCED LIFESTYLE: Achieve professional fulfillment while nurturing a healthy work-life balance, free from weekend or evening hours. We understand the importance of both professional fulfillment and personal well-being.
• COLLABORATIVE TEAM: Join forces with a diverse team of top-notch behavioral health professionals, support staff and empowering leadership. Together, we work towards transforming the lives of our patients.
• IMPRESSIVE RETENTION RATES: Our compassionate, welcoming approach has helped us earn a higher-than-average provider retention rate of 88%.
• COMPREHENSIVE BENEFITS: We prioritize your overall well-being and financial security. Enjoy a full suite of competitive benefits, including medical, dental, fertility, retirement, wellness, profit sharing and more.
• Hourly Compensation: $22.00 - $23.00 Depending on Experience
  

Position Overview: The Payment Recovery Specialist supports all denials management functions, and underpayments made by payers. The Payment Recovery Specialist will also be responsible for conducting root-cause analysis of denials, be responsible for working denials that are escalated to them for review and resolution, work with billing or other departments to develop and maintain all denials management training and guidelines.

Essential Responsibilities

• Conducts root-cause analysis of denials to determine where improvements within processes may be necessary.
• Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs workflows and procedures.
• Collaborates with and provides support to team and management in appeals including, but not limited to, follow-up with providers for letters of medical necessity or retro-authorizations, team escalation of appeals requiring action or drafting letters to payors, follow-up with payors on denials, etc.
• Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
• Uses contract matrices to calculate reimbursement.
• Ensures accounts are paid according to contract guidelines and individual agreements and work payer and contracting teams to obtain accurate payment.
• Answers phone calls from internal and external customers answering questions, taking payments, and resolving issues.
  
  

Supervisory Or Managerial Responsibility

• None
  
  

Other Duties

• Other duties as assigned by management.
  
  

Minimum Qualifications

• High school diploma or general education degree (GED) required. Associate degree preferred.
• Three years of healthcare clerical experience required.
• Experience with Microsoft Office Suite required.
  
  

Location: Remote Position

Family Care Center is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Mental Health Care

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