Payment Recovery Specialist

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.

Essential Responsibilities

• Counsults with management to conduct 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.
• Maintains up-to-date knowledge of payor policies, denial codes, and regulatory requirements, adapting workflows accordingly.

Minimum Qualifications

• A high school diploma or general education degree (GED) required.
• An 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.