Recovery Analyst

Job Title: Recovery Analyst

Reports To: Manager of Recovery

Department: Operations

About The Team

Our mission at PMMC is to continuously improve the financial performance of healthcare organizations so that they have more resources to devote to patient care. PMMC provides revenue cycle management tools to healthcare delivery systems, acute care hospitals, critical access hospitals, academic physician organizations and multi-specialty physician groups. Helping to find additional cash and creating efficient workflow processes allows our clients to improve margins and continue to effectively serve their communities.

Due to the changing healthcare landscape for both providers and consumers, there is more focus on the revenue cycle today than ever before. PMMC is committed to providing healthcare organizations with not only the latest technology, but also the necessary strategy to guide them through the challenges of changing reimbursement, price transparency, and population health management. Together, we can transform the revenue cycle!

About The Role

As a Recovery Analyst at PMMC, you'll play a vital role in the dynamic landscape of healthcare finance. You'll be responsible for meticulously analyzing and recovering underpaid accounts on behalf of our clients from health insurance payers. This role involves a deep understanding of payer policies, effective communication with payers across the country, and the tenacity to ensure claims are fully resolved and properly paid. To excel in this position, you'll need to build strong relationships with payers, master contract interpretation, and skillfully convey the underpaid variances to the payer.

Responsibilities:

• Establish and maintain open lines of communication with PMMC's Recovery clients, hospitals, and payers.
• Present a compelling argument to payers to rectify underpaid claims, supported by thorough research and identification.
• Craft and submit appeal/reconsideration letters to address payer concerns when appropriate.
• Conduct consistent follow-ups with payers to ensure the prompt resolution of each claim.
• Meet or exceed established production goals, reflecting your dedication and expertise.
• Collaborate with the Recovery Auditors and provide feedback to enhance the quality of potentially underpaid accounts.
• Be prepared for other duties and responsibilities that may be assigned at the discretion of management.

Qualifications & Requirements

• A Bachelor’s Degree with two or more years of related work experience.
• A demonstrated track record of successfully interacting with payers, overturning denials, and rectifying underpayments.
• Proficiency in navigating payer contracts, facility billing, and medical terminology.
• Experience in billing and collections.
• Understanding of healthcare terminology to accurately assess claims and discrepancies.
• Proficiency in researching payer policies, regulations, and industry guidelines.
• Proficiency with Microsoft applications.
• The ability to communicate professionally at a high level.

What We Look For

Successful Revenue Recovery Analysts are analytical, organized, persuasive, and proactive professionals who excel in the dynamic and fast-paced world of healthcare finance. They possess a keen eye for detail, a strategic mindset, and a commitment to delivering impactful results in an ever-evolving industry.

Why Join PMMC

PMMC offers a dynamic, growth-focused environment where innovation and teamwork drive success. We are dedicated to innovation, collaboration, and excellence in revenue cycle management. At PMMC, your work drives meaningful results for healthcare systems across the country.

Benefits

Discover a wealth of benefits at PMMC, ranging from comprehensive healthcare plans to continuous learning opportunities, ensuring your well-being and professional development. Enjoy a supportive work environment that values your contributions with competitive compensation packages, flexible PTO and perks designed to enhance your overall work-life balance.

Core Values

Join our team at PMMC. We Grow or Die as individuals and as a collective force, inspiring one another to reach new heights. We Love to Win, not just for ourselves but for our entire team. We constantly Innovate, finding fresh solutions to complex challenges. We pride ourselves on being Productive & Efficient while always striving to Do the Right Thing in all that we do.

If you're ready to be part of a team that embodies these values, we invite you to apply today!

#TeamPMMC

PMMC is an equal opportunity employer. We provide equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity or expression, veteran status, marital or citizenship status or any other status protected by applicable federal, state, or local law.