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Revenue Recovery Specialist II
Knowtion Health. Analyze denied claims to determine underlying reasons for denial .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical terminology and coding, including ICD, CPT, and HCPCS, while effectively analyzing and resolving denied claims. Proficient in revenue cycle management, ensuring compliance with regulations and maximizing reimbursement through ethical billing practices.
Highest-signal resume keywords
Medical Terminology ExpertiseClaims Analysis and ResolutionRevenue Cycle ManagementCritical Thinking SkillsHealthcare Insurance Billing
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
ICD CodingCPT CodingHCPCS CodingClaims AdjudicationPatient AccountingPayer AdjustingMedical CodingRegulatory InterpretationRevenue CodesProcess Improvement
Soft Skills
Critical ThinkingProblem SolvingCommunication
Tools & Technologies
Artiva
Industry Keywords
Healthcare InsuranceRevenue RecoveryClaims ProcessingTimely Filing GuidelinesMotor Vehicle Accident ClaimsWorkers’ Compensation
About the role
Key responsibilities & impact- Analyze denied claims to determine underlying reasons for denial
- Conduct necessary follow-up actions, including preparing and submitting appeals with comprehensive documentation and justification
- Communicate with payors regarding unpaid or underpaid claims
- Resolve account denials and ensure timely, accurate recovery of outstanding claims
- Maintain accurate records of claim activities, appeals, follow-ups, and resolutions in Artiva and client systems
- Ensure compliance with regulations and guidelines governing claims processing and revenue recovery
- Meet timely filing guidelines to maximize reimbursement
- Identify recurring trends, issues, and process improvement opportunities
- Communicate insights and actionable recommendations to management
- Generate revenue through professional billing practices and proper, ethical collection efforts
- Resolve outstanding hospital bills on behalf of patients without collecting money directly from patients
Requirements
What you’ll need- Minimum of 3 years’ experience working for a hospital, a payer, or other relevant revenue cycle area
- Preferred experience in healthcare insurance billing and/or hospital follow-up
- Preferred experience in medical coding, claim adjudication, patient accounting, payer adjusting, and filing and/or settlement of motor vehicle or workers’ compensation accident claims
- Expertise in medical terminology and coding, including 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
- Ability to interpret regulations for Commercial Insurance, CMS, MVA, and Workers’ Compensation
- Valid government-issued photo ID required during screening and/or interviews
- Applicants prioritized from AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, and WV
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Short-term disability
- Long-term disability
- Bonus opportunities
- Paid holidays
- 401(k)
- Generous PTO policy
- Remote work
- Dedicated, distraction-free workspace at home