We are looking for an 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.

• 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. 

• High School graduate or equivalent education.
• 1 to 3 years prior collections or customer service experience required.
• Billing or coding experience preferred.
• Strong oral and written communication.
• Required knowledge of Microsoft applications.

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
• No adverse environmental conditions expected.

Base compensation ranges from $16.00 to $19.00/hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 1/3/2025
Applications are assessed on a rolling basis. We anticipate that the application window will close on 1/8/2024, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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