Kern Family Health Care
Claims Revenue Recovery Analyst - Hybrid/Remote
Kern Family Health Care, Bakersfield, California, United States, 93399
Claims Revenue Recovery Analyst - Hybrid/Remote
Apply for the Claims Revenue Recovery Analyst - Hybrid/Remote role at Kern Family Health Care.
This role is based in Bakersfield, CA, offering a pay range of $28.62/hr – $36.49/hr.
About the role Under the supervision of the Deputy Director of Claims, the Revenue Recovery Analyst will follow organization policies and KHS guidelines, responsible for the recovery of overpayments identified due to various factors including OHC, retro disenrollment, CCS eligible conditions, and incorrect payments. The analyst will process refunds, reversals, and research needed to ensure recoveries are accurate, and manage reprocessing projects. The position maintains check logs, credit sheets, and letters while working closely with finance to coordinate and ensure recovery of monies due to KHS.
Essential Duties and Responsibilities
Credit sheets and credit letters to accounting
Accounting Logs / Check Logs
Prepare advances for accounting and apply refund checks to those advances.
Take EOP vendor calls and assist with EOP questions.
Provider calls regarding recovery requests.
Prepare return check letters.
Post all refund checks received.
Provider disputes related to recoveries.
Recovery letters and follow up.
Follow up calls on non-par providers with outstanding recovery request.
Process recovery claims in claims system.
Refund checks pertaining to TPL.
Notify Senior Support Staff regarding other potential liability (TPL) for notification to be sent to state (DHS).
Review negative balance accounts and contact providers for recovery.
Identify provider billing error trends and report this to supervisor or manager.
Work with Finance and Corporate Services on return mail/checks regarding provider payments.
Handle all refund checks received for supplemental payments including but not limited to GEMT and Prop 56.
Process claims related to reprocessing projects.
Work with finance on HFI Medicare recoveries.
Review weekly report for claim processed for EOB when member does not have medical coverage.
Perform other job‑related duties as required.
Adheres to all company policies and procedures relative to employment and job responsibilities.
Education and Experience High school diploma from an accredited school or equivalent. Minimum of four (4) years of medical claim payment or medical billing processing experience required. Prefer two (2) years’ experience performing claims review for error tracking.
Seniority level Not Applicable
Employment type Full-time
Job function Business Development and Sales. Industries: Hospitals and Health Care
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This role is based in Bakersfield, CA, offering a pay range of $28.62/hr – $36.49/hr.
About the role Under the supervision of the Deputy Director of Claims, the Revenue Recovery Analyst will follow organization policies and KHS guidelines, responsible for the recovery of overpayments identified due to various factors including OHC, retro disenrollment, CCS eligible conditions, and incorrect payments. The analyst will process refunds, reversals, and research needed to ensure recoveries are accurate, and manage reprocessing projects. The position maintains check logs, credit sheets, and letters while working closely with finance to coordinate and ensure recovery of monies due to KHS.
Essential Duties and Responsibilities
Credit sheets and credit letters to accounting
Accounting Logs / Check Logs
Prepare advances for accounting and apply refund checks to those advances.
Take EOP vendor calls and assist with EOP questions.
Provider calls regarding recovery requests.
Prepare return check letters.
Post all refund checks received.
Provider disputes related to recoveries.
Recovery letters and follow up.
Follow up calls on non-par providers with outstanding recovery request.
Process recovery claims in claims system.
Refund checks pertaining to TPL.
Notify Senior Support Staff regarding other potential liability (TPL) for notification to be sent to state (DHS).
Review negative balance accounts and contact providers for recovery.
Identify provider billing error trends and report this to supervisor or manager.
Work with Finance and Corporate Services on return mail/checks regarding provider payments.
Handle all refund checks received for supplemental payments including but not limited to GEMT and Prop 56.
Process claims related to reprocessing projects.
Work with finance on HFI Medicare recoveries.
Review weekly report for claim processed for EOB when member does not have medical coverage.
Perform other job‑related duties as required.
Adheres to all company policies and procedures relative to employment and job responsibilities.
Education and Experience High school diploma from an accredited school or equivalent. Minimum of four (4) years of medical claim payment or medical billing processing experience required. Prefer two (2) years’ experience performing claims review for error tracking.
Seniority level Not Applicable
Employment type Full-time
Job function Business Development and Sales. Industries: Hospitals and Health Care
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