State Licensed Recovery Analyst
Job Summary
To support the recovery of inappropriate pharmacy payments, the full-time remote State Licensed Recovery Analyst will manage claim adjustments, coordinate with external collection agencies, and ensure accurate processing of payment recoveries related to audits and investigations.
Key responsibilities
- Perform and document collection efforts, including claim adjustments and future payment withholding
- Evaluate audits and claims for potential recoupment, making recommendations for actions as needed
- Prepare reporting on recovery processes to support pharmacy and internal business needs
Required qualifications
- Bachelor's degree in Finance, Business, or a related area, or equivalent education and experience
- National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)
- 2 years of work experience in pharmacy operations, including claims processing and billing
- Eligibility to work in the United States without a work visa or residency sponsorship
- Intermediate skill in point of sale and online pharmacy claims processing environment
Complete Job Description
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