Senior Recovery Resolution Specialist

Job Summary

Working remotely on a full-time basis, the Senior Recovery Resolution Specialist will identify, investigate, and resolve claim payment inaccuracies while ensuring compliance with policies and regulations within the healthcare claims domain.

Key responsibilities:

• Provide claims expertise by reviewing, researching, investigating, and resolving healthcare claims and recovery opportunities
• Analyze claim outcomes, identify trends, and communicate findings to support process improvement opportunities
• Ensure adherence to state and federal compliance policies while managing assigned inventory and meeting productivity standards

Required qualifications:

• High School Diploma / GED or equivalent work experience
• 2+ years of experience researching, processing, auditing, or resolving healthcare claims
• Experience interpreting claim details, payment history, and contractual language
• Ability to navigate multiple systems to conduct claim research and analysis
• Willingness to work full-time, Monday through Friday, with flexibility during normal business hours