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Performant is a market leader that recovery services for healthcare. We’re more than brick and mortar – we are about helping people. It’s a dynamic, fast-paced and fun workplace like a start-up, but with the backing of a profitable public company with a history of growth.

We are looking for highly-skilled, talented medical billing and revenue specialists with strong analytical skills. With a well-versed background in Coordination of Benefits and Medicare/Medicaid and procedural challenges regulations; experienced in generating outbound communications to Providers; with proven ability to gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues; and communicate effectively with Providers to recapture payments. 

As a Healthcare Revenue and Recovery Analyst you will be assigned a Provider portfolio with responsibilities to include, but not limited to

Essential Duties:

• Engage in Outbound recovery calls, to Healthcare Carriers and Providers regarding improperly paid claims
• Decision Support- Ability to accurately review supporting documentation provided to Performant, by Providers/Carriers to determine accuracy of finding or overpayment allegation, for Complex appeals and disputes.
• Maintain current knowledge in Medicare and Medicaid practices and regulatory issues that may affect our clients.
• Leverage your knowledge and expertise to research Overpayments and answer questions and/or provide information that will bring to successful resolution and payment.
• Educate Healthcare providers/carriers on their obligation to pay.
• Ability to analyze and understand written communication from insurance companies including explanation of benefits.
• Support internal groups or functions with gathering and interpretation of the billing and collections work to development with knowledge base and understanding of key concepts and terminology in healthcare billing and claims.
• Leverages existing excel skills to create Provider centric reporting on demand, or at Managements request.
• Effectively follow and contribute to continuous improvement of scripts, guidelines and other tools provided to have professional conversations with Healthcare Insurance providers
• Efficiently and diligently work through assigned inventories to meet productivity metrics assigned by management
• Ability to maintain and function in multiple client systems and environments at one time.
• Updates company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, payment commitments, as well as account status updates as applicable.
• Updates company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, payment commitments, as well as account status updates as applicable.
• Arrives to work on-time, works assigned schedule, and maintains regular attendance
• Follows and complies with company and departmental policies, processes and procedures
• Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations
• Successfully completes, retains, applies and adheres to content in required training as assigned.
• Consistently achieve or exceed established metrics and goals assigned
• Demonstrates Performant core values in performance of job duties and all interactions
• Correct areas of deficiency and oversight received from quality reviews and/or management.

Required Skills and knowledge

• Ability to demonstrate, strong written and verbal communication skills
• Basic understanding of revenue cycle management or Medical recovery.
• Strong knowledge and material experience with Healthcare, Medical terminology, Coding, Billing. Preferably a role in recovery or revenue cycle management.
• Demonstrates knowledge in post-payment recovery.
• Demonstrates the ability to solve complex Provider or Carrier billing questions, that assist in the resolution and understanding of the overpayment.
• Communicates effectively with Providers and Carriers to answer any questions and/or provide information that will bring successful payment or other resolution to the account.
• Demonstrated expertise in Medicare and Medicaid plans policy and procedure
• Up to date knowledge in Medicare/Medicaid appeal processing
• Knowledge in Coordination or benefits (COB)
• Demonstrates a high degree of critical thinking and analytical accuracy required to be successful.
• Proven ability to gather and interpret explanation of benefits (EOB) and answer questions and resolve standard as well as complex issues with payments.
• Strong skills using standard office technology; Computer, various applications and navigation of on-line tools and resources.
• Intermediary to Advanced excel skills.
• Applies knowledge learned in training
• Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail.
• Must have the availability to communicate via phone with Providers and or Carriers in a quiet space 5+ hours daily.

Additional Requirements:

•Ability to obtain and maintain client required clearancesas well as pass company regular background and/or drug screening.

•Completion of Teleworker Agreement upon hire, andadherence to the Agreement (and related policies and procedures) including, butnot limited to: able to navigate computer and phone systems as a user to workremote independently using on-line resources, must have high-speed internetconnectivity, appropriate workspace able to be compliant with HIPAA, safety& ergonomics, confidentiality, and dedicated work focus without distractionsduring work hours.

Physical Requirements: 

**NOTE: Must be able to meet requirements for andperform work assignments in accordance with Company policies and expectationson a home remote basis (and must meet Performant remote-worker requirements)until at which time staff may be notified and required to work from aPerformant office location on an ad-hoc or periodic basis.

Basic office equipment required to perform remote workis provided by the company.

•Job is performed in a standard busy office environmentwith moderate noise level (or may be home-office setting subject to Companyapproval and Teleworker Agreement), sits at a desk during scheduled shift, usesoffice phone or headset provided by the Company for calls, making outboundcalls and answering inbound return calls using an office phone system; views acomputer monitor, types on a keyboard, and uses a mouse.

•Reads and comprehends information in electronic(computer) or paper form (written/printed).

•Sit/stand 8 or more hours per day; has the option tostand as needed while on calls; reach as needed to use office equipment.

•Consistently viewing a computer screen and typesfrequently, but not constantly, using a keyboard to update accounts.

•Consistently communicates on the phone as requiredprimarily within the department and company and may include client contacts orother third-party depending on assignment with account holders, may dialmanually when need or use dialer system; headset is also provided.

•Occasionally lift/carry/push/pull up to 10lbs.

Education and Experience

Bachelor’s degree in relevant field or equivalent combination of education and experience.

3+years directly relevant professional working experience in an analytic or recovery role.

Experience in Healthcare Billing and/or Coding

Knowledge or experience with Healthcare, Coordination of benefits or Revenue cycle management.

Other Requirements:

Performant is a Government contractor and subject tocompliance with client contractual and regulatory requirements, including butnot limited to, Drug Free Workplace, background requirements, and clearances(as applicable).

•Must submit to and pass pre-hire background check, aswell as additional checks throughout employment.

•Must be able to pass a criminal background check; mustnot have any felony convictions or specific misdemeanors, nor on state/federaldebarment or exclusion lists.

•Must submit to and pass drug screen pre-employment (andthroughout employment).

•Performant is a government contractor. Certain clientassignments for this position requires submission to and successful outcome ofadditional background and/or clearances throughout employment with the Company.

Employment VISA Sponsorship is not available for thisposition

Job Profile is subject to change at any time.

EEO

Performant Financial Corporation is an Equal OpportunityEmployer.

Performant Financial Corporation is committed tocreating a diverse environment and is proud to be an equal opportunityemployer. All qualified applicants will receive consideration for employmentwithout regard to race, color, national origin, ancestry, age, religion,gender, gender identity, sexual orientation, pregnancy, age, physical or mentaldisability, genetic characteristics, medical condition, marital status,citizenship status, military service status, political belief status, or anyother consideration made unlawful by law.