Are you seeking an exciting opportunity to join a passionate, growing, and dynamic team of professionals who support patients?

A Specialist I, Revenue Recovery Audit consistently generates revenue through professional billing practices, using proper and ethical collection efforts. Knowtion Health works as an ambassador on behalf of patients to resolve outstanding hospital bills and never collects monies from patients. This Specialist must be able to multi-task, prioritize as necessary to timely resolve accounts for payment, and maintain a high level of professionalism when communicating with payers and patients daily. In addition to drafting appeals, Specialists must demonstrate proficient use of web-based client and payer portals along with notation databases.

What’s Attractive to the Right Candidate?

• Knowtion Health is a growing firm in a growing industry. Our status as a leader in this industry means that we have the resources to invest in the business and to innovate.
• Our business is intensely competitive and is constantly evolving. We quickly identify new challenges and develop solutions, so you will not simply be doing what was done last year. Our new employees are frequently pleased and surprised by how quickly we make decisions and adapt to market conditions.
• Knowtion Health culture is inviting and competitive, embracing challenge and celebrating accomplishment; dedicated colleagues striving to provide quality results that have lasting impact.

The Opportunity:

• Using the Artiva workflow management system, follow up on patient bills and claims and manage an inventory from multiple clients with complex audit issues, such as DRG downgrades, ED downgrades, line-item charge audits, medical necessity audits, RAC audits. Depending on the department, the business entities may include any or all the following: commercial health insurance, governmental insurance, and third party administrators
• Analyze information to identify root cause of audited, denied or unpaid claim and determine next steps
• Pursue & obtain information needed to support coding/clinical validation review including correspondence review, validation of recourse remaining through the audit companies and/or payers
• Ensure appropriate timely filing guidelines are met
• Escalate complex, complicated, or challenging accounts to management to ensure accounts are progressing effectively
• Identify and discuss root cause issues with management
• Consequence to errors in judgment are critical (HIPAA violation penalties, lost revenue for hospital client, other penalties, or fines)

What you bring:

• A high level of professionalism
• Adherence to all debt collection rules and regulations
• Adherence to HIPAA requirements
• Moderate computer proficiency including working knowledge of MS Excel, Word, and Outlook
• Organization and documentation skills to ensure timely follow-up and accurate record keeping
• Mathematical ability to calculate rates using addition, subtraction, multiplication, and division
• Familiarity with CPT, ICD coding preferred

The above statements are intended to provide the general nature and level of work being performed by most people assigned to the position. They are not intended to be an exhaustive list of all responsibilities, duties and requirements.

This position is remote and requires a dedicated, distraction-free workspace at home. We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, bonus opportunities, paid holidays, 401k, and a generous PTO policy.

Knowtion Health gives priority to applicants located in the following states: AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, WV