Billing and Revenue Recovery Officer

About the role

The Billing and Revenue Recovery Officer is responsible for preventing, identifying and resolving claim denials while supporting the revenue cycle. The role works closely with clinical, coding and finance teams to ensure accurate billing and timely reimbursement.

Key responsibilities

• Monitor compliance with insurance contracts, DOH guidelines and facility pricing structures.
• Prepare and submit electronic patient invoices and secondary claims on a daily basis.
• Identify, report and correct incorrect or missing charges, collaborating with the Billing Lead or Manager.
• Ensure timely billing of DRG revisions according to policy.
• Analyze and rebill late charges and HCPCS revisions in line with current guidelines.
• Negotiate and communicate clinical claim denials with internal staff and external insurers.
• Participate in payer meetings and present denial performance metrics.
• Maintain claim documentation, track unpaid or partially paid claims, and manage appeals and resubmissions.
• Develop reporting mechanisms to identify denial trends and propose process improvements.

Required profile

• Strong knowledge of universal billing guidelines and payer-specific requirements.
• Experience in denial prevention, claim analysis and revenue cycle operations.
• Ability to work collaboratively across clinical, coding and finance departments.
• Excellent attention to detail and ability to maintain high productivity with accuracy.

Required skills

• HCPCS coding and revisions.
• DRG coding and revisions.
• Electronic claims submission.
• Proficiency with billing software/systems.