Revenue Recovery Specialist II

Knowtion Health; United States; Teletrabalho; USD 60 000 - 90 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical insurance

Dental insurance

Vision insurance

Life insurance

Short term disability

Long term disability

Bonus opportunities

Paid holidays

401k

Generous PTO

Resumo da oferta

Knowtion Health is hiring a Specialist II, Revenue Recovery for a remote role. The position focuses on resolving denied claims and recovering revenue through ethical collection practices. You will interact with payors, manage documentation, and ensure regulatory compliance to optimize reimbursements.

Ideal candidates bring 3+ years in revenue cycle roles, healthcare billing or follow-up experience, and strong knowledge of ICD/CPT/HCPCS coding. A remote work setup is required.

Qualificações

• Minimum 3 years’ experience in hospital, payer, or revenue cycle roles.
• Healthcare billing and follow-up experience for hospitals, coding, and claim adjudication preferred.
• Medical terminology and coding expertise (ICD, CPT, HCPCS, modifiers, revenue codes).
• Advanced critical thinking to define problems, gather data, and draw conclusions.

Responsabilidades

• Analyze denied claims to determine reasons and prepare/submit appeals with documentation.
• Communicate with payors to follow up on unpaid/underpaid claims and recover revenue.
• Maintain up-to-date records of all claim activities in relevant systems.
• Ensure compliance with claims processing regulations and guidelines.
• Identify trends and opportunities for process improvement and report to management.
• Interpret regulations for Commercial Insurance, CMS, MVA, and Workers’ Compensation.

Conhecimentos

Healthcare terminology

Medical coding

Critical thinking

Ferramentas

Artiva

Descrição da oferta de emprego

Are you seeking an exciting opportunity to join a passionate, growing, and dynamic team of professionals who support patients? Knowtion Health is Hiring!

A Specialist II, Revenue Recovery effectively and consistently generates revenue through professional billing practices, using proper and ethical collection efforts. Knowtion Health works as an ambassador on behalf of patients to resolve outstanding hospital bills and never collects monies from patients. This position is remote.

Who We Are?

• Knowtion Health is a growing firm in a growing industry. Our status as a leader in this industry means that we have the resources to invest in the business and to innovate.
• Our business is intensely competitive and is constantly evolving. We quickly identify new challenges and develop solutions, so you won’t simply be doing what was done last year. Our new employees are frequently pleased and surprised by how quickly we make decisions and adapt to market conditions.
• Knowtion Health culture is inviting and competitive, embracing challenge and celebrating accomplishment; dedicated colleagues striving to provide quality results that have lasting impact.

Your Role Will Involve:

• Conduct thorough analysis of denied claims to determine the underlying reasons for denial, and execute all necessary follow-up actions, including the preparation and submission of appeals with comprehensive documentation and justification.
• Communicate with payors to follow up on unpaid or underpaid claims and resolve account denials and ensure timely and accurate recovery of outstanding claims.
• Maintain meticulous and up-to-date records of all claim activities, encompassing appeals, follow-ups, and resolutions in Artiva and client systems as appropriate.
• Ensure strict compliance with all applicable regulations and guidelines governing claims processing and revenue recovery activities.
• Ensure appropriate timely filing guidelines are met for maximum reimbursement
• Identify recurring trends, issues, and opportunities for process improvement, and communicate these insights to management along with actionable recommendations.
• Skilled in interpreting regulations for Commercial Insurance, CMS, MVA, and Workers' Compensation.

What you bring:

• Requires a minimum of 3 years’ experience working for a hospital, a payer or other areas of the revenue cycle considered relevant.
• Preferred experience includes healthcare insurance billing and/or follow up for hospitals, medical coding, claim adjudication, patient accounting, payer adjuster, filing and/or settlement of accident claims (motor vehicle or worker’s compensation) and other experience as determined based on the program
• Expertise in medical terminology and coding (ICD, CPT, HCPCS, modifiers, procedures, bill types, diagnosis, and revenue codes)
• Advanced critical thinking skills; ability to define problems, collect data, establish facts and draw valid conclusions

The above statements are intended to provide the general nature and level of work being performed by most people assigned to the position. They are not intended to be an exhaustive list of all responsibilities, duties and requirements.

Compensation and Benefits:

This position is remote and requires a dedicated, distraction-free workspace at home. We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, bonus opportunities, paid holidays, 401k, and a generous PTO policy.

Knowtion Health gives priority to applicants located in the following states: AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, WV

Photo Identification and Image Capture Notice

As part of our hiring process, candidates are required to present a valid government-issued photo ID during screening and/or interviews.

We may also capture a photograph during the screening or interview process for identity verification, security, and record-keeping purposes. All identification documents and images will be handled in accordance with applicable privacy laws and accessed only by authorized personnel.

By proceeding with your application, you acknowledge and consent to this process.