Claims Recovery Analyst

Job Summary

Researching and resolving payment discrepancies, the full-time Claims Recovery Analyst will process refund requests and identify overpayment trends, working in a remote environment.

Key responsibilities

• Research and validate claims to identify and initiate recovery of overpayments
• Monitor and follow up on recovery requests, ensuring compliance with established procedures
• Create and submit detailed reports on recovery outcomes and trends

Required qualifications

• High school diploma or general education degree
• At least one year of experience as an Analyst III or equivalent
• In-depth knowledge of Medi-Cal regulations related to claims processing
• Familiarity with procedure coding, medical terminology, and industry standard payment practices
• Basic knowledge of data analysis and reporting tools