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Payment Recovery Specialist

Company: Family Care Center
Location: Colorado Springs
Posted on: September 24, 2022

Job Description:

Position Summary: 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 paymentAnswers phone calls from internal and external customers answering questions, taking payments, and resolving issues.Other Duties:Performs other related duties as assigned by management.Supervisory or Managerial Responsibility: None Core Responsibilities:Be available to work as scheduled and report to work on time.Be willing to accept supervision and work well with others.Helps to drive Five Star clinic performance.Comply with all organizational policies, the Employee Handbook, Code of Conduct, FCC Way and required annual training. Fosters an inclusive workplace where diversity and individual differences are valued and leveraged to achieve the vision and mission of the organization.Adheres to safe working practices and always follows all organizational safety policies and procedures. If applicable, wears appropriate PPE as outlined by relevant policy and procedures.Demonstrates compliance with all state, federal and all other regulatory agency requirements. Ensure strict confidentiality of all medical records, PHI, and PII. 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.Work Environment and Conditions: Continually required to sit; continually required to utilize hand and finger dexterity; continually required to talk or hear. Noise level in the work environment is usually moderate to loud. Occasionally lift and/or move more than 15 pounds. Specific vision abilities required: close vision; distance vision; color vision; peripheral vision; depth perception and ability to adjust or focus.Hourly Pay Range:$20.00 - $24.00 Depending on Experience.Family Care Center offers competitive compensation and benefits packages with the ability to also maintain work-life balance. Full time employees are eligible for 401k, vision, dental, medical, life, and employee wellness and discount plans.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.

Keywords: Family Care Center, Colorado Springs , Payment Recovery Specialist, Other , Colorado Springs, Colorado

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