Job Details
Brief Description
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.
Requirements
Education/Experience and Other Requirements
- Bachelor s degree in Accounting, Business Administration, or other finance-related area is preferred (OR a combination of education and experience resulting in comparable knowledge and abilities).
- 3+ years in business, insurance, or managed care industry settling patient accounts or a related healthcare area such as utilization management, case management, or hospital audit and reimbursement.
- Experience in health-related agreements involving rate and language analysis, audit and reimbursement, claims denial, and appeals preferred.
- Knowledge or willingness to learn fundamentals of coding CPT/HCPCS, ICD-10, and DRG is preferred.
- Willingness to submit to drug and background screenings.
Expertise Needed
- Excellent communication and interpersonal abilities to collaborate effectively with stakeholders.
- Analytical mindset with the ability to use data-driven insights to inform decision-making.
Summary
Benefits
- Three weeks of paid time off in first year (more added with tenure)
- Medical, dental, vision, long-term disability, and life insurance
- Flexible Spending Account (FSA) and Health Savings Account (HSA) options
- Generous 401(k) with employer match up to 6%
Exact Billing Solutions Culture
Integrity. Dependability. Attention to detail. All our team members exhibit these qualities when it comes to doing business. And when it comes to the business of supporting a team, as a company, we offer no less to our team members. We re a fast-paced, growing company delivering services that allow our clients to spend more time helping people. At the end of the day, it s people, not numbers, that drive our success.
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