A Revenue Recovery Specialist is responsible for researching and analyzing accounts for assigned clients, and payers, and to diagnose reasons for underpayment/non-payment of claims. The job description entails evaluating appropriate actions needed for correcting the account and maintaining track of all identified issues and errors. Job duties found on the Revenue Recovery Specialist Resume are – serving as a role model, mentor, advocate, and motivator to recovering individuals and to help prevent relapse and promote long-term recovery; maintaining project logs, reports, and records in appropriate files and databases, providing recovery education to service recipients for every phase of recovery journey from pre-recovery engagement, providing a model for both people in recovery and staff, assisting recovering persons to identify their interests, and goals; and promoting self-advocacy among recovering persons.
Apart from possessing a degree in relevant fields, a keen understanding of the revenue cycle and opportunity for uncollected revenue is desired. Other traits include the following – excellent analytical skills, exemplary attention to detail, critical thinking skills, excellent verbal and written communication skills, aptitude for and the ability to adapt to multiple software systems, and integrity.
Objective : Results oriented Revenue Recovery Specialist professional with a Financial Analyst background who has successfully led numerous initiatives in areas such as medical sales, electronic sales, cost savings, financial analysis, reporting, and employee development. An effective communicator with a proven track record of collaborating with others to establish relationships and building trust while driving sales results and financial goals.
Skills : Microsoft Office, Account Reconciliation, Desktop Support, Customer Service, Collections, Information Technology, Call Center Management.
Description :
Monthly metrics collection of data and reporting Enhanced the protection of our revenues by conducting revenue recovery activities and ensuring that our findings are communicated consistently both internally and to the customer.
Accomplished in the most cost effective manner possible.
Helped maintain a financially strong company earning, a reasonable profit, and providing long term competitive returns.
Included helping develop a master operating plan with input from Industrial Engineering, Plant Engineering and Human Resources.
Established planning calendar for monthly site visits.
Helped Maximize utilization of assets (People and equipment) to include scale accuracy.
Made sure that supplies are adequate and available.
Experience
2-5 Years
Level
Executive
Education
Business Administration
Revenue Recovery Specialist Resume
Headline : Have nearly 20 years of experience working in the medical field with the majority of that time spent working with Account Receivables, more specifically, insurance carrier and patient account follow up and collections. Proficient in: Microsoft Office including Word, Excel and Outlook. Medical software includes: Medical Manager, AdvantX, EncoderPro, Zirmed, Emdeon and a variety of insurance websites for follow up and appeals purposes. I'm looking for a part time job in the evenings and weekends.
Skills : Auditing, Customer Service, Problem Solving.
Description :
Maintained the AR for Delmarva Surgery Center which is a multi-specialty facility.
Reviewed and monitored patient accounts to determine timely payments or lack thereof.
Gathered patient and account information to present to our Executive Director who then approves each account to be forwarded to our collection attorney and testifying in court as needed.
Gathered medical records for requests from attorney offices, insurance companies and patients.
Insuranced verification and notifying patients of benefits and/or amounts due prior to their date of service and handling any concerns patients may have with regards to their benefits.
Made sure all authorizations are completed and are correct according to the scheduled procedure.
Reviewed and monitor all insurance carriers outstanding AR, i.e.: Workers Compensation, Auto Insurance, Medicare, Medicaid and all private and third party payors.
Experience
5-7 Years
Level
Executive
Education
High School Diploma
Revenue Recovery Specialist Resume
Objective : To secure a motivating and challenging position in the healthcare field where I can utilize my past experience and newly acquired skills as a Medical Office Specialist, Reimbursement Specialist, Benefits Coordinator and COBRA administrator. Also to pursue a rewarding career within a growing company that provides opportunity for advancement and brings forth daily challenges involving the knowledge I've acquired through my studies and experiences.
Skills : Microsoft Office, Microsoft Word, Microsoft Excel, Medical Terminology, Computer Literate, Medical Billing, Medical Coding, Medical Records.
Description :
Researched and identified payment discrepancies from various sources.
Compiled and analyzed data to make recommendations.
Worked with financial and clinical departments collaboratively.
Reviewed contract validation, updates, and interpretation.
Resolved underpaid claims in an effective and timely fashion.
Reviewed payor policies for impact on reimbursement.
Presented data and effectively communicated to various levels of end-users.
Experience
2-5 Years
Level
Junior
Education
BA In Accounting
Revenue Recovery Specialist Resume
Headline : As a Revenue Recovery Specialist, responsible for Demonstrating a basic understanding of products, services, and customer-facing technology solutions offered by UPS along with their features and business applications; describing general customer profiles targeted by the company.
Responsible for medical collections for intra-operative monitoring.
Daily Collections responsibilities include but are not limited to status calls, appeals, appeal status calls, claim re-submission, and patient billing and collecting for Blue Cross Blue Shield Plans and other various payers.
Utilized multiple direct and indirect portals.
Completed account adjustments.
Knowledged of Medicare Guidelines; and billing using the Medicare LCD (local coverage determination).
Negotiated payment proposals with various healthcare cost management entities Attend Webinars as needed to stay up to date on changes of IONM industry reimbursement policies and procedures.
Electronically set up BCBS region to submit claim reconsiderations, appeals, disputes, and recoupments.
Experience
5-7 Years
Level
Executive
Education
Diploma
Revenue Recovery Specialist Resume
Summary : To secure a position that will lead to a lasting working relationship in the field of public relations, provider relations, credentialing, contracting, and or customer service.
Skills : Linux, Technical Support, Windows Server, Operating.
Description :
Monitored, analyzed and appealed government, managed care and commercial payer hospital and outpatient hospital-based patient claim payment variances in order to optimize revenue recovery, assess contract compliance, and communicate contract and reimbursement issues to management.
Performed a variety of tasks related to developing a knowledge-based understanding of government payer regulations, terms of third party payer regulations and contracts, coverage and benefit plans, coordination of benefits, payment terms, and all other conditions affecting payment, the appeal of payment variances, and correct payment calculation.
Performed a variety of tasks related to the muse of internal data and systems to identify, document, track, and summarize payment variances to determine appropriate actions to be taken so as to initiate appeals and to address inaccurate reimbursement in a timely manner.
Performed a variety of tasks to analyze internal processes, technical system issues, and payer processing/system issues and to determine/communicate corrective actions in order to resolve payment variances.
Performed a variety of tasks in conjunction with Managed Care Contracting and Government Payers Department staff, to achieve the most accurate payer and contract modeling in the decision support system.
Performed a variety of tasks to document appeals of payment variances and reimbursement amounts recovered thru the various appeals processes.
Performed special projects as assigned, in order to resolve recovery issues, settlements with payers, and optimize revenue recovery.
Experience
7-10 Years
Level
Management
Education
B.S. In Criminal Justice
Revenue Recovery Specialist Resume
Headline : To obtain a challenging Revenue Recovery Specialist position within the Medical/Billing department in a hospital or office setting. Also within a highly diversified company with the potential for advancement.
Skills : Managing Skills, Communication Skills, Administrative Skills.
Description :
Trained staff members for Infusion and Urgent Care billing.
Payment Posted for Medicare and major medical.
Used Knowledge of and willingness to learn fundamentals of coding CPT/HCPCS, ICD-9/ICD-10, DRG's and APC's Computer proficiency with MS Office, denials management software, hospital billing systems and third-party payer systems and websites Above average problem solving and communication skills, function as a self-starter with initiative to pay attention to detail and demonstrates follow through on issues.
Reduced administrative costs by decreasing the amount of correspondence that must be sent through the mail.
Ensured account analysis is validated prior to distribution.
Identified products for which customers have canceled or lapsed orders, developing a list of customers that may be able to be contacted.
Developed a list of contacts for the customers on the list.
Experience
5-7 Years
Level
Junior
Education
MS
Revenue Recovery Specialist Resume
Headline : Highly qualified Revenue Recovery Specialist with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : Excel, Excel, Word, Word, Medical Billing, Claims Processing, Claims Processing, Patient Care, Data Entry, Data Entry, Filing, Inventory, Typing, Typing.
Description :
Utilized Company policy or client contract when negotiating repayment, including payment in full, compromise of balance, ongoing monthly payment arrangements, or entitlement programs available.
Accurately assess the consumer's financial condition by conducting thorough inquiries.
Determined the reason for delinquency and find creative solutions to resolve the situation.
Tracked and maintained all customer accounts throughout the collection process ensuring prompt payment recovery of all outstanding balances.
Performed customer account maintenance activities to include account reviews, reconciling aging levels, verifying account balances, applying for payments, monitoring collection activities, and updating accounts in compliance with established corporate policies and procedures.
Adhered to the State and Federal regulations pertaining to collection activities.
Met corporate standards for call quality assurance and structure.
Experience
5-7 Years
Level
Executive
Education
High School Diploma
Revenue Recovery Specialist Resume
Headline : Seeking to gain employment where my skills can be utilized that may lead to advancement within the company. Highlights Experienced Vehicle Operator Documented Cargo CDL Qualified Vehicle Training and Certifying Secret Security Clearance Customer Service Communication and Computer systems.
Skills : Great Customer Service, Training Skills, Maintenance Skills.
Description :
Received packages from incoming unloading trucks and make sure there were no damages to any merchandise or the box itself holding the merchandise.
Damaged packages or packages that don't belong, it was our duty to take care of the packages by repairing them.
Able to lift more than 70+ in that time period.
Had to adapt to working in the fast-paced environment and rotate into other places where people needed an extra hand.
Used Strength & hard work, because before this job I never lifted heavy items back to back as I did there.
Followed up with insurance company online and via phone to ensure claims have been received and are being processed.
Experience
5-7 Years
Level
Executive
Education
MS
Revenue Recovery Specialist Resume
Headline : Organized, independent worker with strong time-management skills. Enthusiastic, resourceful graduate with academic and professional background in food business and healthcare. Ability to establish priorities and meet challenges head-on. Eager to gain diverse job experience.
Skills : Training Skills, Implementational Skills, Developing Skills.
Description :
Performed follow-up on health insurance claims.
Analyzed claims to determine payment variances.
Analyzed contracts.
Prepared reconsiderations and appeals.
Prepared medical necessity and authorization denial appeal letters.
Pursued underpayments from insurance companies.
Implemented and maintained Local Exchange Carrier (LEC) records, accounts, and informational Databases on 50+ phone companies.
Experience
5-7 Years
Level
Executive
Education
Bachelor Of Science
Revenue Recovery Specialist Resume
Headline : Seeking a position where I can utilize my customer service and technical skills and where there is opportunity for personal growth and advancement. I am creative, motivated and a quick learner. I have been recognized and appreciated for my dependability, hard work, honesty, dedication and commitment to promoting a team environment. I look forward to working as an integral member of your team.
Skills : Microsoft Office, Epic, Meditech, Insurance Verification, Customer Service, Powerpoint, Adobe, Collections, Vendor Management, Windows Xp, Data Analysis, Financial Analysis, Medical Terminology.
Description :
Reviewed and followed up of all medical claims submitted to insurance for payment.
Reviewed and appealed of denied claims.
Account reviewed for correct charges billed.
Corrected of all patient data to insure correct billing of insurance.
Obtained information and process applications for Hospital Charity Programs.
Led assistant to supervisor.
Worked in conjunction with supervisor running the department.
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