[Hiring] Revenue Recovery Specialist II @Knowtion Health

Role Description

Are you seeking an exciting opportunity to join a passionate, growing, and dynamic team of professionals who support patients? Knowtion Health is Hiring!

A Specialist II, Revenue Recovery effectively and consistently generates revenue through professional billing practices, using proper and ethical collection efforts. Knowtion Health works as an ambassador on behalf of patients to resolve outstanding hospital bills and never collects monies from patients. This position is remote.

Your Role Will Involve:

• Conduct thorough analysis of denied claims to determine the underlying reasons for denial, and execute all necessary follow-up actions, including the preparation and submission of appeals with comprehensive documentation and justification.
• Communicate with payors to follow up on unpaid or underpaid claims and resolve account denials and ensure timely and accurate recovery of outstanding claims.
• Maintain meticulous and up-to-date records of all claim activities, encompassing appeals, follow-ups, and resolutions in Artiva and client systems as appropriate.
• Ensure strict compliance with all applicable regulations and guidelines governing claims processing and revenue recovery activities.
• Ensure appropriate timely filing guidelines are met for maximum reimbursement.
• Identify recurring trends, issues, and opportunities for process improvement, and communicate these insights to management along with actionable recommendations.
• Skilled in interpreting regulations for Commercial Insurance, CMS, MVA, and Workers' Compensation.

Qualifications

• Requires a minimum of 3 years’ experience working for a hospital, a payer or other areas of the revenue cycle considered relevant.
• Preferred experience includes healthcare insurance billing and/or follow up for hospitals, medical coding, claim adjudication, patient accounting, payer adjuster, filing and/or settlement of accident claims (motor vehicle or worker’s compensation) and other experience as determined based on the program.
• Expertise in medical terminology and coding (ICD, CPT, HCPCS, modifiers, procedures, bill types, diagnosis, and revenue codes).
• Advanced critical thinking skills; ability to define problems, collect data, establish facts and draw valid conclusions.

Benefits

• This position is remote and requires a dedicated, distraction-free workspace at home.
• We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, bonus opportunities, paid holidays, 401k, and a generous PTO policy.