Description

JOB SUMMARY

The Revenue Recovery Analyst is responsible for coordinating, analyzing, and executing all activities related to the identification, reporting, billing, and recovery of outstanding receivables. This includes provider overpayments, insured service reimbursements, capitation deductions, and stop-loss collections. The role ensures timely and accurate financial reconciliation, partners with internal departments and external stakeholders, and supports revenue integrity across all managed groups.

Requirements

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: High school diploma or equivalent.

Preferred: Bachelor’s degree in Business Administration, Finance, Accounting, or related field.

Experience 

Minimum: 5+ years of experience in the healthcare industry, preferably managed care. Strong background in claims processing and claims auditing. Experience with reimbursement methodologies and financial reconciliation.

Preferred: Experience analyzing capitation,   stop-loss, and health plan payments. Prior work using EZ-Cap or similar   claims processing systems.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Certification(s)

None required; certifications in medical billing or healthcare finance are a plus.

Skills, Knowledge & Abilities

· Strong knowledge of current HCFA/DOC regulatory guidelines.

· Ability to interpret claims data, reimbursement rules, and contractual provisions.

· Proficiency in Microsoft Office (Word, Excel).

· Strong analytical, problem-solving, and investigative skills.

· Ability to communicate professionally with providers, payers, and internal departments.

· High level of accuracy, confidentiality, and attention to detail.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. The role involves primarily sedentary work with light physical effort, including occasionally lifting items up to 10 pounds as well as periodic bending, stooping, and reaching associated with filing tasks. Mentally, the position requires sustained concentration on detailed analytical work, the ability to manage multiple priorities under time-sensitive conditions, and strong problem-solving and decision-making capabilities. Work is performed in a standard office environment, though there may be occasional travel between office locations as operational needs arise.

PAY RANGE

$35.00 - $40.00 / hourly