Claims Recovery Analyst

Job Summary

A company is looking for a Claims Recovery Analyst I.

Key Responsibilities

• Conduct focused and random claims audits and facilitate claim adjustments
• Research and contact providers regarding negative balance collections
• Monitor departmental compliance with state and CMS requirements and manage data reporting

Required Qualifications, Training, and Education

• Minimum of two years of claims operations experience required
• Experience in Medicaid Coordination of Benefits (COB) and Medicare Secondary Payor (MSP) preferred
• Prior experience in encouraging timely repayment from providers preferred
• Understanding of the healthcare industry, specifically in Operations
• GED or High School diploma or equivalent combination of education and relevant experience in healthcare