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)
The Payment Audit Specialist (PAS) reports to the system director of Finance and is responsible for reviewing Payer Contract variances as generated by the System’s Contract Modeling software, or otherwise identified for further investigation. The PAS is also responsible for following up with the affected payers (in conjunction with colleagues in Reimbursement, System Revenue Cycle and Payer Contracting) in order to achieve successful resolution of outstanding variances. The PAS will also provide as requested periodic updates regarding Variance Conversion percentage and dollars re-harvested from the System’s Contract Underpayment efforts.
Essential Function
High School Diploma Required
Associates Degree Preferred
Work Experience (education can be substituted for experience)
1-3 years of health care finance experience required.
Knowledge, Skills and Abilities