Recovery Resolution Consultant

Job Summary

As a full-time Recovery Resolution Consultant working remotely, the candidate will conduct root cause analyses, perform complex data evaluations, and manage project delivery to support innovative solutions in healthcare payment integrity.

Key responsibilities:

• Conduct root cause analysis for insourcing concepts, including research and verification of identified claims
• Perform complex data and conceptual analyses while delivering project requirements and documentation
• Support operational readiness through preparation of documentation and training for cross-value stream transformation activities

Required qualifications:

• High School Diploma / GED
• 3+ years of experience researching medical claims, including provider contracts and claim payment policies
• 3+ years of hands-on experience with reviewing and pricing E&I UNET claims
• Experience analyzing large data sets to identify trends and patterns
• Ability to work any shift between 8:00 am - 5:00 pm EST, Monday - Friday