Revenue Recovery Specialist, VA

Job Description

REQUIREMENTS

• 1-3 years experience working with various government, military and third-party VA contracted payers including The Veterans Administration, VA Community Care Network, Tricare and ChampVA required
• A High School Diploma or GED is required
• A high level of professionalism
• Adherence to HIPAA requirements
• Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook
• Familiarity with CPT, ICD coding preferred
• Experience with MEDITECH and EPIC preferred

RESPONSIBILITIES

• Using the Artiva workflow management system, follow up on patient bills and claims in order to recover revenue from the responsible business entity in a team-based setting.
• Analyze information to identify root cause of denied or unpaid claim and determine next steps
• Pursue & obtain information needed to overturn claim denials, including patient & responsible party information, medical necessity, employer information, accident information
• Ensure appropriate timely filing guidelines are met for maximum reimbursement
• Escalate complex, complicated or challenging accounts to management to ensure accounts are progressing effectively
• Identify and discuss root cause issues with management
• Consequence to errors in judgment are critical (HIPAA violation penalties, lost revenue for hospital client, other penalties or fines)

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