Payment Recovery Specialist is responsible for analysis of denied reimbursement claims. Ensures appropriate insurance coverage for compliance standards and revenue generation. Being a Payment Recovery Specialist monitors, evaluates, and reviews all cost reporting in support of claims. Coordinates with departments and insurance companies to correct errors as necessary. Additionally, Payment Recovery Specialist requires a bachelor's degree in area of specialty. Typically reports to a supervisor or manager. To be a Payment Recovery Specialist typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
Position Summary:
The Payment Prep Specialist prepares data for payment posting, as well as coordinates other payment
preparation efforts in the department(i.e., credit card reports/processing, mail processing, working
reports, preparing deposits, etc.).
Job Duties:
• Professionally represent our clients
• Ensure check and balance protocols are enforced(credit card payments, deposits,
etc.)
• Process all credit cards daily
• Pull credit card payment reports daily
• Update client payment spreadsheets daily
o Add credit card totals
o Send daily totals to client(s)
• Identify problematic payments and communicate with payer to resolve
o Incorrect amount, discrepancies, no signature, etc.
o Insufficient funds
• Return checks to patients
• Process zero pays
• Post patient payments and credit cards
• Reroute payments/correspondence as necessary
o Send payments received to appropriate lockbox
o Former client correspondence
• Open/sort mail
• Look up credit claim batches
• Identify and report account problems, along with trends and patterns
• Execute additional payment-related and client service functions as necessary
• Pull EOB's
• Other duties as assigned.
Required Knowledge, Skills, and Abilities
• Excellent communicator
• Understanding of health insurance and medical billing
• 10-key by touch
• Organized and focused
• Able to promptly learn and utilize software; familiarity with MedFM preferred
• Experience in accounting is a plus.
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