Associate Director - Projects (Healthcare Revenue Recovery Leader)

at  Cognizant

About us: Cognizant is a leader in Healthcare RCM solutions, dedicated to optimizing financial operations for healthcare providers. We are committed to delivering innovative technology and services that improve efficiency, accuracy, and provider satisfaction in the revenue cycle process.
Job Summary: We are seeking a detail-oriented Healthcare Revenue Recovery Leader to manage underpayment and overpayment functions within our Provider RCM segment. The ideal candidate will have a strong understanding of healthcare billing processes, insurance guidelines, and the ability to analyze financial data to ensure accurate revenue recovery.

QUALIFICATIONS:

• Bachelor’s degree in healthcare administration, finance, or a related field preferred.
• Minimum of 3 years of experience in healthcare revenue cycle management, specifically in underpayment and overpayment functions.
• Strong knowledge of medical billing, coding, and insurance processes.
• Proficient in healthcare billing software and Microsoft Office Suite.
• Excellent analytical, problem-solving, and communication skills.
• Ability to work independently and collaboratively in a fast-paced environment.

• Underpayment Analysis: Investigate and resolve underpayment issues by reviewing claim adjustments, denial codes, and payment remittances. Collaborate with payers to recover lost revenue.
• Overpayment Management: Identify, analyze, and resolve overpayments through comprehensive audits of claims and payments. Coordinate with internal teams to facilitate refunds as needed.
• Data Analysis: Utilize financial and operational data to identify trends in underpayments and overpayments, providing actionable insights to improve revenue cycle performance.
• Reporting: Prepare and present regular reports on revenue recovery activities, highlighting key metrics, challenges, and opportunities for improvement.
• Compliance: Ensure compliance with all regulatory requirements and internal policies related to billing and revenue recovery practices.
• Collaboration: Work closely with billing, coding, and collections teams to ensure accurate and timely resolution of payment issues.
• Training and Education: Provide training and guidance to team members on revenue recovery processes and best practices.