Healthcare Reclamation Analyst

Role Overview

• Leverage solid knowledge and expertise in COB/TPL/Recovery to gather and review in-house data with payer correspondence to determine proper order of benefits and resolve primacy issues.
• Successfully solves data or record discrepancies and/or issues.
• Leverage your knowledge and expertise in COB/TPL/MSP to review documentation and eligibility, investigate the file to determine proper order of benefits and answer questions and/or provide information that will bring to successful payment or other appropriate account action.
• Communicate effectively with carriers to determine primacy; answer questions and/or provide information that will bring to successful payment or other appropriate account action.
• Contact Healthcare Insurance carriers regarding claim responses.
• Educate Healthcare Insurance carriers on the Coordination of Benefits rules and appropriately respond to complex questions.
• Analyze and understand written communication from insurance companies including explanation of benefits (EOBs).
• Support internal groups or functions with gathering and interpretation of the claims billing process and denial management.
• Effectively follow and contribute to continuous improvement of scripts, guidelines and other tools provided to have professional conversations with Healthcare Insurance carriers, and/or providers.
• Efficiently and diligently work through assigned inventories to consistently meet productivity metrics assigned by management.
• Leverage knowledge and expertise to research various scenarios that will bring to successful resolution and payment (i.e.. eligibility research and claims appeals).

Requirements

• Minimum 2 years of directly relevant progressive experience in billing reclamation or directly related role demonstrating application of similar depth of skills and knowledge and capability required for the position.
• Minimum 12 months relevant collections/receivable experience with consistent high production results.
• Experience demonstrating research and analytical skills relevant to the position.
• High School diploma or GED.
• Relevant college courses or certification a plus.

Benefits

• medical
• dental
• vision
• HSA/FSA options
• life insurance coverage
• 401(k) savings plans
• family/parental leave
• paid holidays
• paid time off annually