Astrana Health
Overview
Job Title: Manager - Claims Revenue Recovery Department: Ops - Claims Ops Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Compensation: $90,000 - $110,000 / year Working Environment
Hybrid work setting, with potential need to attend meetings onsite. Office is located at 1600 Corporate Center Drive, Monterey Park, CA 91754. What You\'ll Do
Lead the claims recovery team in achieving operational goals and recovery targets Monitor and report on key departmental KPIs, including but not limited to:
Recovery rate Average claim cycle time
Cost savings and efficiency metrics Use KPI data to identify trends, gaps, and opportunities for process improvement Supervise the day-to-day operations of the revenue and recovery claims team, ensuring accuracy, efficiency, and compliance Monitor claims processing and recovery activities to identify trends, issues, and opportunities for improvement Ensure proper review, validation, and resolution of claim discrepancies, denials, overpayments, and underpayments Collaborate with payers, providers, and internal teams to address revenue recovery and reconciliation issues Develop and implement policies, procedures, and performance standards aligned with organizational goals Generate and analyze reports to track performance, recovery outcomes, and key metrics Train, coach, and mentor team members; provide regular feedback and performance evaluations Support audits, compliance reviews, and reporting requirements related to claims recovery, notices, and revenue integrity Escalate unresolved or complex issues to management with recommendations for resolution Foster a positive, collaborative team culture focused on accountability and continuous improvement Oversee incoming calls from provider offices related to overpayment notices Other duties as assigned Qualifications
Education: Bachelor’s degree in healthcare administration, business, finance, or related field (or equivalent experience) Experience: 5-7 years in healthcare claims, revenue cycle, or recovery operations At least 4 years in a supervisory or team lead role Knowledge/Skills: Strong understanding of healthcare claims processing, reimbursement methodologies, and regulatory requirements Familiarity with payer contracts, denials management, and revenue recovery strategies Proficiency with claims systems, reporting tools, and Microsoft Office Suite (Excel, Word, Outlook) Excellent analytical, organizational, and problem-solving skills Strong leadership, communication, and interpersonal abilities
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Job Title: Manager - Claims Revenue Recovery Department: Ops - Claims Ops Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Compensation: $90,000 - $110,000 / year Working Environment
Hybrid work setting, with potential need to attend meetings onsite. Office is located at 1600 Corporate Center Drive, Monterey Park, CA 91754. What You\'ll Do
Lead the claims recovery team in achieving operational goals and recovery targets Monitor and report on key departmental KPIs, including but not limited to:
Recovery rate Average claim cycle time
Cost savings and efficiency metrics Use KPI data to identify trends, gaps, and opportunities for process improvement Supervise the day-to-day operations of the revenue and recovery claims team, ensuring accuracy, efficiency, and compliance Monitor claims processing and recovery activities to identify trends, issues, and opportunities for improvement Ensure proper review, validation, and resolution of claim discrepancies, denials, overpayments, and underpayments Collaborate with payers, providers, and internal teams to address revenue recovery and reconciliation issues Develop and implement policies, procedures, and performance standards aligned with organizational goals Generate and analyze reports to track performance, recovery outcomes, and key metrics Train, coach, and mentor team members; provide regular feedback and performance evaluations Support audits, compliance reviews, and reporting requirements related to claims recovery, notices, and revenue integrity Escalate unresolved or complex issues to management with recommendations for resolution Foster a positive, collaborative team culture focused on accountability and continuous improvement Oversee incoming calls from provider offices related to overpayment notices Other duties as assigned Qualifications
Education: Bachelor’s degree in healthcare administration, business, finance, or related field (or equivalent experience) Experience: 5-7 years in healthcare claims, revenue cycle, or recovery operations At least 4 years in a supervisory or team lead role Knowledge/Skills: Strong understanding of healthcare claims processing, reimbursement methodologies, and regulatory requirements Familiarity with payer contracts, denials management, and revenue recovery strategies Proficiency with claims systems, reporting tools, and Microsoft Office Suite (Excel, Word, Outlook) Excellent analytical, organizational, and problem-solving skills Strong leadership, communication, and interpersonal abilities
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