Managed Care Analyst 1 Recovery

Hesperia, CA 92345

Post Date: 05/16/2018 Job ID: 42722 Profession: Claims

Looking to work for a large player in the High Desert market? This is the job for you!!This MSO provides full range of managed healthcare services, including the effective management of risk arrangements, for independent practice associations, medical groups, hospitals, and other managed care organizations. This MSO is looking for a Managed Care Analyst/ Recovery Specialist to join their team at their main office in Apple Valley.

What will I be doing?

Recovery Specialist will be responsible for the analysis and evaluation of claims data

Working on EzCap to analyze data

Recovery of claims discrepancies

Review revenue recoveries, retro-terminations, duplicate payments, and other over payment errors

Resolve issues regarding member eligibility for PCP s and Specialty Providers

Ensure member information is accurate

Research and resolve requests from financial department

Work with health plans and employer groups to verify member eligibility

Correspond with members via electronic mail, calls, and respond to voicemails

Maintain data integrity

What experience should I have?

ICD 10, HCPCS, and CPT Coding experience

Health Plan and Vendor Contracting experience

Expert Excel and Microsoft Office skills

Experience using EZ-CAP

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