Payment Recovery Specialist, Medicaid Billing, Fully Remote!

Role Summary:   The Payment Recovery Specialist follows-up on claim status, review payer responses, and assists with denial management. The Payment Recovery Specialist coordinates with departments and insurance companies to ensure follow-up on all appeals, payments and denials, bringing claims to resolution.   Role Responsibilities: Resolves billed claims and referred denials Manage assigned work queues Performs contact with payers via phone calls and payer portal Documents related claim status activity Communicates pertinent payer trends to the Team Leader Review payment accuracy Upload copies of claim status and remits as needed Accountable for meeting established productivity measures and goals Assist with client inquires Participates in departmental meetings Role Requirements: Knowledge of and experience reviewing Explanation of benefits (EOB) and Remittance Advise (RA) Strong knowledge of insurance types, associated administrative guidelines, and terminology Strong knowledge of payer portal navigation Understanding insurance payment methodologies Basic understanding of appeals/denial resolution processing needs Strong communication skills and problem-solving ability Strong analytical and organizational skills Knowledge of State policies/procedures on determining eligibility and claims processing Some knowledge of and experience with billing process and procedures Some knowledge of and experience with Hospital Patient Billing systems; language, flow of work, processes, and procedures

Salary : $18 - $23