job description
Join Connext as a Payment Recovery Specialist and play a pivotal role in ensuring accurate reimbursement and process improvements in the healthcare financial ecosystem. This remote opportunity allows you to work from the stunning locations of Bali while enjoying a 25% differential pay on top of your base salary.
As a Payment Recovery Specialist, you will manage denials, underpayments, and escalated payer issues, ensuring that healthcare providers receive the reimbursements they deserve. Your expertise will directly impact financial accuracy and operational efficiency, making a tangible difference in the healthcare industry.
If you are detail-oriented, analytical, and passionate about financial recovery in healthcare, this role offers a unique blend of professional growth and work-life balance in one of the world's most sought-after destinations.
Responsibility
- Investigate and resolve denied or underpaid claims by analyzing payer responses and contractual agreements.
- Identify trends in payment discrepancies and recommend process improvements to minimize future denials.
- Collaborate with internal teams, including billing and clinical staff, to gather necessary documentation for appeals.
- Prepare and submit appeals to payers, ensuring compliance with regulatory and contractual requirements.
- Monitor and track the status of appeals, following up with payers as needed to expedite resolutions.
- Maintain accurate records of all recovery activities, including documentation of communications and outcomes.
- Provide regular reports on recovery metrics, including success rates and financial impact.
- Stay updated on industry changes, including payer policies and healthcare regulations, to ensure compliance and optimize recovery strategies.
Qualifications
- Bachelor's degree in Healthcare Administration, Finance, Business, or a related field.
- Minimum of 2 years of experience in healthcare revenue cycle management, with a focus on payment recovery or denial management.
- Strong understanding of medical billing processes, payer contracts, and healthcare reimbursement methodologies.
- Proficiency in using healthcare billing software and Microsoft Office Suite, particularly Excel.
- Excellent analytical and problem-solving skills, with the ability to interpret complex data and identify trends.
- Strong communication skills, both written and verbal, with the ability to negotiate effectively with payers.
- Detail-oriented with a high degree of accuracy in documentation and reporting.
- Ability to work independently in a remote setting while maintaining productivity and collaboration with the team.