You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Payment Recovery Specialist. This is a fully remote role dedicated to navigating the complexities of insurance denials and appeals within the mental and behavioral health space. We are looking for a tenacious, detail-oriented professional who can not only resolve individual claims but also think strategically to identify root causes and stop future denials.

• Denial Management: Investigate, manage, and resolve insurance claim denials through timely follow-up and formal appeals.

• Financial Accuracy: Address overpayments and underpayments to ensure the organization is reimbursed at the correct contracted rates.

• Strategic Problem Solving: Analyze denial trends to identify holistic solutions and process improvements that prevent recurring issues.

• Payer Communication: Actively contest and recover outstanding reimbursements through rigorous communication with insurance payers.

• Productivity: Maintain high-volume output with a target of approximately 55 touches per day.

Qualifications

Required Experience

• Experience: 2+ years in healthcare revenue cycle, specifically focused on denials, appeals, and insurance follow-up.

• Payer Knowledge: Strong understanding of insurance processes, payer guidelines, and how to effectively "fight" for claim payment.

• Technical Proficiency: Experience navigating payer portals and clearinghouses (e.g., Availity).

Soft Skills & Personality

• Tenacity: A "tough" personality capable of handling pushback from insurance companies.

• Patient-Centric: The ability to maintain a professional and empathetic bedside manner when discussing complex billing issues with patients.

• Analytical Mindset: A natural curiosity for the "investigative puzzle" of revenue cycle management.Preferred Skills

• Background in mental or behavioral health revenue cycle.

• Familiarity with the InSync system.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Additional Requirements

• Monday – Friday, 7:00 a.m. – 5:00 p.m.
• Fully remote position

Required Employment / Compliance Language: Medix is an Equal Opportunity Employer (EOE).

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.