Recovery Specialist Team Lead

We are seeking a Recovery Specialist Team Lead to join one of Houstons largest Independent Physician Associations. This position is fulltime and 100 inoffice role Monday through Friday 8:00am5:00pm with some flexibility to start an hour earlier. Therefore the Recovery Specialist Team Lead must live in the Houston area.

The Recovery Specialist Team Lead is responsible for overseeing the daily activities of the overpayment recovery team while maintaining core responsibilities including identifying investigating and recovering medical claim overpayments. This involves analyzing medical records billing codes and payer contracts to detect discrepancies collaborating with providers and payers to recoup funds and ensuring compliance with healthcare regulations such as HIPAA. The Recovery Specialist Team Lead also involves managing a small team developing recovery programs and leveraging specialized software to detect overpayment patterns. Additionally the Recovery Specialist Team Lead works closely with internal departments to resolve disputes and enhance recovery processes requiring strong problemsolving customer service and adaptability.

Resumes may be submitted directly or via email to

Responsibilities:

• Leading and managing a small team of recovery specialists.
• Developing new programs and projects for INETs recovery team to increase and maintain positive recovery capital.
• Scrutinizing submitted healthcare claims for potential overpayments by comparing billing codes medical records and payer contracts.
• Identifying errors such as incorrect coding duplicate billing or noncovered services.
• Analyzing claim data using specialized software to identify patterns and trends of overpayments.
• Contacting providers and payers to discuss identified overpayments and initiate recovery process.
• Preparing and submitting claim adjustments or appeals to recover funds.
• Negotiating settlements with providers and payers to resolve overpayment disputes.
• Creating policies and procedures to maintain compliance.
• Adhering to HIPAA regulations and other healthcare compliance standards when handling patient data.
• Maintaining detailed records of claim reviews recovery efforts and communication with providers and payers.
• Tracking recovery metrics and reporting progress to management.
• Collaborating with internal teams like billing coding and patient accounts to identify potential overpayment issues.
• Communicating effectively with providers and payers to resolve claim disputes and facilitate recovery processes.

Experience & Qualifications:

• Healthcare billing knowledge and thorough understanding of medical billing codes (CPT ICD10 HCPCS) and payer reimbursement guidelines.
• Ability to analyze complex medical records and billing data to identify overpayments.
• Strong problemsolving skills to address complex claim issues and find solutions.
• Excellent written and verbal communication skills to interact with providers payers and internal stakeholders.
• Familiarity with healthcare claims processing systems and data analysis tools.
• AAPC CPC certified or AHIMA CCS certification.
• Thorough understanding of medical billing codes (CPT ICD10 HCPCS) and payer reimbursement guidelines.
• Ability to analyze complex medical records and billing data to identify overpayments.
• Strong problemsolving skills to address complex claim issues and find solutions.
• Excellent written and verbal communication skills to interact with providers payers and internal stakeholders.
• Familiarity with healthcare claims processing systems and data analysis tools.

Benefits:

This position offers a competitive benefits package which includes:

• Group benefits include medical dental vision company paid $25k life with the option to add more voluntary life insurance coverage for employees and their family STD company paid LTD 401k matching and a variety of supplemental coverages such as hospital cancer legal etc. available to the employee and their family.
• Employee funded FSA program.
• Paid Time Off ranging from 528 days depending on length of service.
• Profit Sharing Bonus Program
• 100 Employer Paid Pension Plan after 5 years
• Access to company gym and locker rooms in Houston offices

About ROI Search Group:

ROI Search Group is a staffing and executive search firm based near Indianapolis IN specializing in direct hire contract and contracttohire placements along with executive and specialized searches. Our proven methodology allows us to attract top talent while supporting candidates in their career progression. By aligning with the priorities of both clients and candidates we create longterm successful partnerships. At ROI Search Group we are dedicated to providing exceptional staffing and executive search solutions that drive organizational growth and career advancement. We take pride in our commitment to excellence integrity and building meaningful professional connections.

Required Experience:

Unclear Seniority