Workers' Compensation Revenue Recovery Specialist

Responsible for evaluating referred workers' compensation accounts to confirm they meet state-specific guidelines, identify the responsible payer, ensure bills and records are submitted within required timelines, and verify payment accuracy. When claims are unpaid or underpaid, the specialist prepares and submits appeals to recover correct reimbursement.

Key responsibilities include managing a multi-client inventory of complex accounts, handling new and priority cases, working aged and high-dollar accounts, reviewing accounts that require coding and utilization review input, resolving delays in payment, maintaining detailed account documentation, communicating professionally with patients, employers, and payer representatives, learning client-specific workflows, and using portals, client systems, and databases to document and resolve accounts.