Senior Recovery Resolutions Analyst Medical Claims


Philadelphia, PA

Industry: Accounting, Finance & Insurance


Less than 5 years

Posted 11 days ago

  by    Mason Ingling

Research issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules. Investigate, recover and resolve all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. Investigate and pursue recoveries and payables on subrogation claims and file management.




*** Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization.


*** Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits information


*** Process recovery on claims


*** Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance


Required Qualifications:


*** Experience with claims auditing and researching claims information.


*** Experience analyzing data and identify cost saving opportunities.


*** Experience working with medical claims platforms, claims payment accuracy, and recovery of claims payments.


Competitive compensation, growth potential and an excellent benefits package, which includes: health insurance, dental, 401(k) with company match, profit sharing, short-term disability, life insurance and more.


Please reference #38291125 when responding.Education Requirements: Bachelor DegreeMinimum Experience Requirements: 2-5 yearsJob City Location: PhiladelphiaJob State Location: PAJob Country Location: USA

Diedre Moire Corporation, Inc.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER and our employment decisions are made without regard to race, color, religion, age, sex, national origin, handicap, disability or marital status. We reasonably accommodate individuals with handicaps, disabilities and bona fide religious beliefs. Jobs Career Position Hiring. CONSIDERED  Top 10 Job Site Top 10 Careers Site Clinical Risk Manager Health Insurance Nurse RN Clinical Risk Specialist Nurse Practitioner Family Nurse Physicians Assistant Medical Stop Loss Stop Loss Insurance Claims Registered Nurse Medical Insurance


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$80K - $130K