Payment Recovery Specialist

Summary

Family Care Center is a behavioral health provider focused on transforming lives through accessible, high-quality care. The Payment Recovery Specialist manages denials, underpayments, appeals, payment accuracy, and account issues while collaborating with internal teams and payors to secure timely reimbursement and maintain accurate records.

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
• Other duties as assigned by management

Skills

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

Qualifications

Must Haves

• High school diploma or general education degree (GED) required
• Three years of healthcare clerical experience required
• Experience with Microsoft Office Suite required
• Experience with Payer Portals and systems required

Nice to Haves

• Associate degree preferred
• Experience working advanced follow-up at minimum and denials/appeals experience strongly preferred

Benefits

• Engaging wellness program
• Volunteer events
• Team activities
• Clear paths for career advancement at every level
• Professional development and personal growth
• Work-life balance with no weekend or evening hours
• Medical benefits
• Dental benefits
• Fertility benefits
• Retirement benefits
• Wellness benefits
• Profit sharing