REVENUE RECOVERY SPECIALIST - Follow Up Team

University of Missouri-Columbia; Columbia Township (MO); Remote; USD 30,000 - 48,000; Full time

Benefits offered by this job

Work from home program

Job summary

University Physicians in Columbia, MO seeks a Revenue Recovery Specialist to review denials and lead reconsiderations to maximize revenue. The role requires analyzing payer policies, CPT coding, and medical records, and communicating trends to leadership. Remote work eligibility is available.

Minimum qualifications include a bachelor’s degree and 3+ years in healthcare billing, insurance, or managed care. Strong analytical skills and experience with denial management are preferred.

Qualifications

• Bachelor’s degree required or equivalent experience in healthcare/finance fields.
• 3+ years in business acumen, insurance or managed care within healthcare revenue cycle.
• Experience with denials analysis, appeals, and reimbursement processes preferred.

Responsibilities

• Review denials and craft reconsiderations/appeals to payers for revenue recovery.
• Identify and communicate trending denials and reimbursement issues to Leadership and Managed Care for escalation.
• Perform root cause analyses of denials to identify broken internal revenue cycle processes.
• Identify and communicate trending internal billing issues to Leadership to ensure compliant billing with payers.
• Participate in special projects (aging AR analysis, pre-billing tasks) as assigned.

Skills

Business acumen

Insurance industry

Managed care

Hospital reimbursement

Education

Bachelor’s degree in Accounting, Business Administration, Finance, Health Related Professions, Nursing or equivalent

Job description

Hiring Department

University Physicians

Job Description

#upjobs

Denials review and analysis: Utilize a combination of payer policies/contract guidelines, knowledge in CPT coding and analysis of medical records in order to formulate reconsiderations/appeals to payers leading to positive outcome for revenue recovery.

Identify and communicate trending denials/reimbursement issues to Leadership and Managed Care Department for further escalation with payers in order to recover revenue in a timely manner.

Perform root cause analysis of denials utilizing multiple systems in order to identify broken internal revenue cycle processes and future solutions in order to maximize revenue for billed services.

Identify and communicate trending internal billing issues due to payer contract/reimbursement guidelines to Leadership in order to establish correct billing in compliance with payer.

Special projects as assigned (ex: trending denial root cause analysis, pre-billing tasks as needed, aging AR analysis, etc.)

Position is eligible for the University Physicians work from home program.

Shift

Monday - Friday

Minimum Qualifications

A bachelor's degree in Accounting, Business Administration, Finance, Health Related Professions, Nursing or an equivalent combination of education and experience from which comparable knowledge and abilities can be obtained is required.

Minimum of three years experience in business acumen, insurance or managed care industry, hospital patient accounts or a related health-care area such as utilization management, case management or hospital audit and reimbursement is required.

Preferred Qualifications

Niche Professional Interests: Experience in health related contractual analysis involving rate and language analysis, audit and reimbursement, claims denial and appeals experience is preferred.

Anticipated Hiring Range

Salary Range: $22.00 - $34.74 hourly

Grade: PAT - 007

University Title: REVENUE RECOVERY SPCLST

Internal applicants can determine their university title by accessing the Talent Profile tile in myHR.

Application Materials

In addition to the Online Application, please provide Resume and cover letter.

Sponsorship Information

Employment visa sponsorship is not available for this position.

Benefit Eligibility

This position is eligible for University benefits. As part of your total compensation, the University offers a comprehensive benefits package, including medical, dental and vision plans, retirement, paid time off, short- and long-term disability, paid parental leave, paid caregiver leave, and educational fee discounts for all four UM System campuses. For additional information on University benefits, please visit the Faculty & Staff Benefits website at https://www.umsystem.edu/departments-staff/human-resources/benefits-retirement

Equal Employment Opportunity

The University of Missouri is an Equal Opportunity Employer.

To request ADA accommodations, please call the Director of Accessibility and ADA at 573-884-7278.