Revenue Recovery Representative Job

Summary

Independently investigates and resolves a variety of complex customer inquiries including but not limited to: complaints and billing related issues. Some inquiries will require: the ability to negotiate with and/or counsel the customer, collaboration with multiple departments, negotiation skills as well as a clear understanding of company policy and procedures. Researches paid claims to ensure accuracy of insurance payments of either overpaid or underpaid claims. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

Knowledge/Skills/Abilities

• Knowledge in healthcare insurance.
• Knowledge of healthcare billing and claims terminology.
• Excellent verbal, interpersonal, and customer service skills.
• Ability to read and comprehend moderately complex written material, such as healthcare contracts.
• Ability to set priorities coordinates multiple tasks, organize tasks, and maintain control workflow.
• Ability to maintain working relationships with co-workers, other departments or areas.

Key Job Responsibilities

• Performs contract payments and billing analysis to ensure accurate reimbursement.
• Determines the resolution of payment variances and/or credit balances.
• Contracts, negotiates and schedules payment, refunds or recoupment as needed from payers for accuracy of account closure.
• Maintains well-organized accounts with a high degree of accuracy and sound judgement.
• Collections and maintenance of payer issues with regards to payments received.

Physical Requirements

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.