Job description
Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good - from the operating room to the boardroom, we are driven by our unique passion to live God's love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.
We're looking for someone to join our team as a Revenue Recovery Associate who:
Assists the revenue recovery team in determining underpaid claims made by managed care payers and/or other defined payers. Identifies underpaid claims, records in the patient accounting system, and presents to the payers detailing the reimbursement discrepancies according to contractagreements.
Essential Functions:
- Performs variance reviews on variance inventory. Generates appeals/reconsiderations/requests for processing for claims paid below the expected reimbursement amount.
- Maintains underpaid account inventory, ensuring active and current follow-up.
- Maintains monthly communication with AH entities to obtain needed documentation to properly pursue underpayments, achieve collection recovery, if applicable and initiates coding and billing reviews for claims, if applicable.
- Provides feedback related to health plan name assignments, and adjustment/posting issues. Collaborates with the appropriate staff regarding contract and payer practice issues in order to improve revenue integrity.
- Tracks trends of underpayments per facility and provide recommendations to the managed dare department for the purpose of providing decision support in contract negotiations.
- Performs other job-related duties as assigned.
You'll be successful with the following qualifications:
Education:
- High School Education/GED or equivalent: Preferred
- Associate's / Technical Degree or equivalent combination of education/related experience: Preferred
Work Experience:
- Two years of reimbursement experience with managed care payors in an acute healthcare facility: Preferred
Required Licenses/Certifications:
- Certified Revenue Cycle Representative (CRCR) Certification*through HFMA: Preferred
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
The estimated base pay for this position is $18.40 - $27.58. Additional individual compensation may be available for this role through years of experience, differentials, extra shift incentives, bonuses, etc. Base pay is only a portion of the total rewards package and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information.
Apply to learn more about our total compensation and benefits!
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