Recovery Analyst

🔥 2 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🧐 Analyst

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Identify, research and investigate possible claims overpayments from internal and external reports • Determine compliance with benefit plans, provider contracts, and policies and procedures regarding claims payment accuracy • Summarize research results for provider overpayment collections • Interact with providers regarding collections, adjustments, and problems • Interact with outsourced vendors and support overpayment identification efforts • Report additional areas where overpayments may have been or are being made • Prepare reports by extracting data to investigate additional exposure areas • Control exception amounts sent directly to providers for collection • Review Finance-recorded cash receipts for amounts sent in error to other sources • Send follow-up letters, record and monitor cash receipts, and issue monthly activity reports • Coordinate with outsourced vendors when receipts are misdirected • Work with the claims adjustment team to ensure errors are adjusted, especially when reconciliations are required • Complete additional departmental responsibilities and other assigned duties • Comply with all policies and standards

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • One year of claims processing experience or a solid understanding of claims processing preferred • Undergraduate degree and/or equivalent experience • Minimum one year experience in a high production, high volume atmosphere • Ability to identify, research and investigate possible claims overpayments • Knowledge of benefit plans, provider contracts, and policies and procedures as they relate to claims payment accuracy • Ability to prepare reports by extracting data • Ability to interact with providers, outsourced vendors, claims adjustment teams, and Finance • Must comply with all policies and standards

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation