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Payment Recovery Specialist

Roles & Responsibilities

  • High school diploma or GED required
  • Associate degree preferred
  • Three years of healthcare clerical experience required
  • Experience with Microsoft Office Suite and payer portals/systems required

Requirements:

  • Conducts root-cause analysis of denials to identify process gaps and trends, escalating high-risk issues with recommended next steps.
  • Supports payor appeal and reconsideration efforts, including gathering letters of medical necessity, retro-authorizations, clinical documentation, and drafting or escalating payor appeal letters with timely follow-up.
  • Identifies and resolves account issues efficiently, using critical thinking and collaborating in team-based problem-solving to develop solutions.
  • Reviews contract matrices to calculate expected reimbursement and validate payment accuracy; monitors payments for compliance and coordinates with payor relations to correct underpayments.

Job description

Description

IT’S MORE THAN A JOB. IT’S A CALLING.

At Family Care Center, we are on a mission to transform lives by elevating behavioral health care. Our journey began in 2016 when two U.S. Army Veterans founded Family Care Center to help service members, Veterans and their families. We continue that tradition today, caring for people of all ages across a broad range of conditions with nearly 30 outpatient clinics in communities across Arizona, Colorado, Florida, Tennessee and Texas.

If you'd like to work for one of the nation's fastest-growing behavioral health providers, collaborating with other committed team members and making a positive impact on your community, we look forward to hearing from you.

Transforming lives is our life’s work.

  • CARING & SUPPORTIVE CULTURE: We support you so you can support our patients. Our positive environment is complemented by an engaging wellness program, volunteer events, team activities and more.
  • UNPARALLELED GROWTH OPPORTUNITIES: We offer clear paths for career advancement at every level, fostering your professional development and personal growth.
  • BALANCED LIFESTYLE: Achieve professional fulfillment while nurturing a healthy work-life balance, free from weekend or evening hours. We understand the importance of both professional fulfillment and personal well-being.
  • COLLABORATIVE TEAM: Join forces with a diverse team of top-notch behavioral health professionals, support staff and empowering leadership. Together, we work towards transforming the lives of our patients.
  • IMPRESSIVE RETENTION RATES: Our compassionate, welcoming approach has helped us earn a higher-than-average provider retention rate of 88%.
  • COMPREHENSIVE BENEFITS: We prioritize your overall well-being and financial security. Enjoy a full suite of competitive benefits, including medical, dental, fertility, retirement, wellness, profit sharing and more.
    • Hourly Compensation: $22.00 - $23.00 Depending on Experience

Position Overview: The Payment Recovery Specialist supports all denials management functions and underpayments made by payers. The Payment Recovery Specialist will also be responsible for conducting root-cause analysis of denials, be responsible for working denials that are escalated to them for review and resolution, work with billing or other departments to develop and maintain all denials management training and guidelines.

Essential Responsibilities:

  • Conducts thorough root‑cause analysis of denials to identify process gaps, trends, and opportunities for improvement, escalating high‑risk, urgent, or systemic issues to management with clear summaries and recommended next steps.
  • Researches, analyzes, and synthesizes complex information from multiple systems and data sources; uses judgment and experience to support findings and assists in designing or refining workflows and procedures.
  • Supports appeal and reconsideration efforts, including obtaining letters of medical necessity, retro‑authorizations, clinical documentation, and assisting with drafting or escalating payor appeal letters; performs timely follow‑up with payors to secure resolution.
  • Identifies and resolves account issues efficiently, using critical thinking to develop alternative solutions; collaborates effectively in team‑based problem‑solving and maintains professionalism when interacting with individuals experiencing stress or heightened emotions.
  • Reviews and applies contract matrices to calculate expected reimbursement and validate accurate payment.
  • Monitors payments to ensure compliance with contract terms and collaborates with payor relations and contracting teams to correct underpayments, discrepancies, or missing information.
  • Responds to inbound calls and inquiries from internal teams, patients, payors, and third parties to provide information, accept payments, resolve account concerns, and ensure positive customer experiences.
  • Utilizes payor portals, EOBs, and remittance data to verify claim status, payment accuracy, and outstanding documentation needs.
  • Documents all account activity thoroughly and accurately in the practice management system to ensure transparency, continuity, and compliance with organizational standards.
  • Maintains up‑to‑date knowledge of payor policies, denial codes, and regulatory requirements, adapting workflows accordingly.

Supervisory or Managerial Responsibility: 

  • None

Other Duties:

  • Other duties as assigned by management.

Minimum Qualifications:

  • High school diploma or general education degree (GED) required. Associate degree preferred.
  • Three years of healthcare clerical experience required.
  • Experience working advanced follow-up at minimum and denials/appeals experience strongly preferred.
  • Experience with Microsoft Office Suite required. Experience with Payer Portals and systems required.

Location: Remote

Family Care Center is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need. 

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