Revenue Recovery & Denials Specialist

Brown University Health; Providence (RI); On-site; USD 28,000 - 45,000; Full time

Job summary

Brown University Health in Providence, RI seeks a Claims Follow-Up Specialist to manage outstanding and denied claims across a large physician multi-specialty practice. Under general supervision, you will review denials, correct entries, and resubmit as needed to support timely revenue cycle performance.

You will stay current with payer updates, maintain HIPAA compliance, and coordinate with internal departments to obtain missing information.

Qualifications

• Equivalent to a high school graduate with knowledge of third-party billing including ICD, CPT, HCPCS, and 1500 forms.
• One to three years of relevant professional billing experience; Epic experience a plus.

Responsibilities

• Review denied claims, correct them in the system and resubmit corrected/appealed claims via written correspondence, fax, or electronic submission.
• Identify and analyze denials and implement corrective measures to resolve payer errors.
• Maintain knowledge of payer updates via listservs, provider updates, webinars, meetings and websites.
• Understand and maintain HIPAA compliance when handling patient information.
• Contact internal departments to obtain missing or erroneous information on a claim to prevent adjudication delays.
• Report denial trends to supervisor to identify revenue delays.
• Answer telephone inquiries from 3rd party payers and route unusual requests to supervisor.
• Retrieve requested medical records documentation based on third-party requests.
• Refer complex accounts to supervisor for additional review per procedures.
• Work with management to improve processes, increase accuracy, create efficiencies and achieve department goals.
• Maintain quality assurance, safety, environmental and infection control in accordance with policies.

Skills

Billing knowledge

HIPAA compliance

Communication skills

Problem solving

Attention to detail

Education

High school diploma

Tools

Epic

Job description

Brown University Health in Providence, RI seeks a Claims Follow-Up Specialist to manage outstanding and denied claims across a large physician multi-specialty practice. Under general supervision, you will review denials, correct entries, and resubmit as needed to support timely revenue cycle performance.

You will stay current with payer updates, maintain HIPAA compliance, and coordinate with internal departments to obtain missing information.