Revenue Recovery Specialist – Exact Billing Solutions

Lauderdale Lakes, FL

About Exact Billing Solutions

Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental health, and autism fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation. With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies.

Growth Opportunity in Medical Billing

If you're an experienced healthcare/insurance finance professional looking for a position in a growing company where your initiative and skills will be recognized, perhaps you belong with Exact Billing Solutions as a Revenue Recovery Specialist!

The Recovery Specialist is responsible for monitoring, analyzing, and appealing outpatient-based claim payment variances for behavioral healthcare cases with the goal of optimizing revenue recovery, assessing payor agreement compliance, and communicating reimbursement issues to management.

What You'll Do

• Use internal data and systems to research delinquent or underpayment accounts, identify and document them, and track and summarize payment variances to determine appropriate actions to be taken.
• Document appeals of payment variances and reimbursement amounts recovered.
• Help develop a knowledgebase and understanding of payor regulations or requirements, terms of Single Case Agreements (SCAs), third-party payor regulations, payment agreements, coverage and benefit plans, coordination of benefits, payment terms, and all other conditions affection payment.
• Analyze internal processes, technical system issues, and payor processing/system issues and determine/communicate corrective actions to resolve payment variances.
• Perform special projects to resolve recovery issues, settle with payors, and optimize revenue recovery.