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CommonSpirit Health

Manager Claims Recovery

CommonSpirit Health, Bakersfield, California, United States, 93399

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Manager Claims Recovery

– CommonSpirit Health

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Manager Claims Recovery

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CommonSpirit Health

Job Summary and Responsibilities

The Claims Recovery Manager leads recovery operations within the MSO Claims department. This role oversees efforts to identify, validate, and recoup overpayments, and enhance controls to prevent future payment errors. The Recovery Manager works closely with internal audit, provider dispute resolution, and finance to maximize cost recovery, reduce payment errors, and support contractual compliance.

Job Requirements

High School Graduate or GED

Minimum 5 years of progressive experience in healthcare claims recovery, payment integrity, or post‑payment audit functions, preferably within a multi‑plan MSO or delegated entity.

Minimum 2 years of people management or team leadership experience

Strong working knowledge of managed care contracts, provider reimbursement methodologies, and recovery‑related policies (e.g., COB, TPL, retro reviews).

Proficiency in Microsoft Excel; familiarity with claims adjudication platforms (e.g., QNXT, EZCAP).

Preferred Qualifications

Bachelor's degree in Healthcare Administration, Business, Finance, or related field or equivalent work experience.

Experience managing vendor recovery relationships or large‑scale recovery initiatives.

Familiarity with audit tools, denial management, and provider relations workflows.

Knowledge of Medicare Advantage, Commercial, and Medi‑Cal managed care recovery requirements.

Where You’ll Work

Dignity Health Management Services Organization (Dignity Health MSO) builds a system‑wide integrated physician‑centric, full‑service management service organization structure. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state‑of‑the‑art, flexible Health & Welfare benefits package.

Pay Range

$39.18 – $58.28 /hour

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