Employer: Cotiviti
Job Details
Description
We are looking for a Recovery Resolution Specialist to join our Yield Management team! This role will facilitate the collection of funds for the client and maintains exceptional provider relations. Works closely with audit team, payers and providers to understand claims and or concepts to facilitate effective communication and collection. Engages in verbal and written communication involving the provider, audit staff and client. Identifies problems in the collection process for escalation to the appropriate parties.
For the safety of our employees and those considering employment with Cotiviti, we are currently conducting all interviews virtually. In addition, the majority of the Cotiviti team is currently working remotely, and we are onboarding new hires remotely as well. As we monitor the pandemic, these arrangements may change and we will update accordingly.
Key Responsibilities:
- Prepares Collections Letters. Prepares collection letters in accordance with policy and ensure they are sent out to providers within established guidelines.
- Follow-up on Outstanding Claims. Follows established policies and procedures to collect identified claims. This includes contacting the providers to verify receipt of the claims and to obtain the status of any outstanding claims. Responsible for responding to correspondence, requesting additional information from providers, preparing documents, and other administrative tasks.
- Investigates Claim Disputes. Investigates claim disputes as required. Identifies issues timely and escalate to appropriate parties. Provides accurate information, supporting documentation, and effective communication to complete recovery process.
- Documents Activities Utilizing Established Tools and Systems. Documents details in the system. Utilizes with increasing proficiency, proprietary reports, tools and systems required to perform duties.
- Meets or Exceed Standards for Productivity. Maintains productivity goals and standards set by the department. Insures all department rules and processes are followed. Alerts manager of system issues or other issues impacting productivity.
- Meets or Exceeds Standards for Quality. Achieves the expected level of quality set by the department. Verifies completeness and accuracy of work. Alerts manager of issues or concerns impacting quality of work.
Requirements:
- High School graduate or equivalent education.
- 1 to 3 years prior collections experience strongly preferred.
- Billing or coding experience preferred.
- Strong oral and written communication.
- Required knowledge of Microsoft applications.