Claims Analyst/Recovery Analyst

  • location: Franklin, TN
  • type: Temp to Perm
  • salary: $24 - $29 per hour
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job description

Claims Analyst/Recovery Analyst

job summary:
CLAIMS AUDITOR/RESOLUTION ANALYST

Contract-to-hire: $49,000-$52,500

Job Description

Analyst for Commercial Data Mining (CDM). The role will be reviewing client adjusted claims that were not identified as overpayments by CDM. The analyst will be expected to review all adjusted claims for their assigned client monthly. This is a revenue-producing budgeted new ad. This position cannot be absorbed as department staff is at capacity and this role falls outside of the normal scope of the Production Claims Auditor role. By not filling this role, Commercial Data Mining will not be able to meet the expectations set with the client.

Team: Commercial Data Mining total employees are 200+; position will be part of a client team of 4-6

 
location: FRANKLIN, Tennessee
job type: Contract
salary: $24 - 29 per hour
work hours: 9 to 5
education: Bachelors
 
responsibilities:
Responsibilities: The primary role of the Leakage Analyst is to review missed revenue opportunities from our claims auditors. They will be responsible for categorizing the missed opportunity and identifying ways to capture that opportunity going forward.

  • Review all monthly client adjustments
  • Learn and fully understand client systems, trending and test file processes, and the current production inventory portfolio
  • Identify training opportunities within existing production cases
  • Create and complete lead tickets and test files for client
  • Review top denial reasons for training opportunities, potential rebuttals back to the client, and query enhancement
 
qualifications:
Required:

  • Bachelor's Degree or higher
  • Strong understanding of Claims, Auditing, Reimbursement, or Data Analysis/Data Mining
  • Intermediate Microsoft Office skills, especially with Outlook and Excel (run pivot table, V-Lookups, If/Then and What If statements)
  • Creative, Outside-The-Box Thinker
  • Above Average Math Skills
  • Motivated Quick Learner
  • Natural Skeptic
Degrees/Majors: Math, Statistics, Science, Actuarially, Philosophy, STEM, or Music (these have all had high success in this position)

 
skills:
  • Strong understanding of Claims, Auditing, Reimbursement, or Data Analysis/Data Mining
  • Intermediate Microsoft Office skills, especially with Outlook and Excel (run pivot table, V-Lookups, If/Then and What If statements)

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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