Sr. Healthcare Reclamation Analyst

Machinify
United States
Workplace: RemoteFull timeUSD 52,000 - 58,000Function: Healthcare (Clinical, Medical, Wellness)Experience: 4+ yearsSkills: ["Communication","Critical thinking","Analytical accuracy","Interpersonal skills","Customer service mindset"]

Review and analyze large volumes of client data and payer correspondence to determine eligibility, primacy, and recovery actions. Resolve complex billing and record discrepancies using COB/TPL/Recovery expertise, including interpreting EOBs and researching eligibility and claims appeals. Communicate with carriers to drive successful payments or appropriate account actions, document outcomes in company systems, and support continuous improvement of workflows, reporting, and new client program setup.

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FursaFursa
Machinify
Machinify
20 hours ago

Sr. Healthcare Reclamation Analyst

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Source: Company careers pageValidated by: Fursa AI
Last checked: 8 hours agoStatus: Live

Job Summary

Review and analyze large volumes of client data and payer correspondence to determine eligibility, primacy, and recovery actions. Resolve complex billing and record discrepancies using COB/TPL/Recovery expertise, including interpreting EOBs and researching eligibility and claims appeals. Communicate with carriers to drive successful payments or appropriate account actions, document outcomes in company systems, and support continuous improvement of workflows, reporting, and new client program setup.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Mid level

Key Responsibilities

  • •Use COB/TPL/Recovery knowledge to gather and review in-house data and payer correspondence to determine order of benefits and resolve primacy issues.
  • •Investigate and resolve complex data/record discrepancies and eligibility questions, including researching scenarios for successful payment and claims appeals.
  • •Communicate with carriers to determine primacy, answer questions, and provide information leading to successful payment or appropriate account action.
  • •Analyze written carrier communication (including EOBs) and document 277 rejections and explanations to address claim and payment issues.
  • •Collaborate on continuous improvement of workflows and systems, support new client program development, and maintain productivity and quality metrics.

Pay and Benefits

Salary: USD 52,000 - 58,000
Perks:Health InsuranceDentalVision401kFsa/hsa

Key Requirements

  • •4+ years of progressive experience in billing reclamation/recovery, denial management, and/or reclamation, including Coordination of Benefits, Third Party Liability, and/or Recovery.
  • •1+ year of experience leading or making strong contributions to operations workflow, data reporting/analysis, and initiatives such as new client or program setup.
  • •Strong knowledge of healthcare, medical terminology, and medical coding, preferably in recovery/auditing/research roles.
  • •Demonstrated ability to gather, research, interpret, and document data for complex problem solving, including analyzing 277 rejections/EOBs.
  • •Must protect patient privacy and follow HIPAA standards and applicable federal/state regulations; ability to obtain and maintain required clearances and background/drug screening.
Experience:4+ yearsHealthcareMedical codingDenial managementBilling reclamationRecoveryAccounts receivable
Skills:CommunicationCritical thinkingAnalytical accuracyInterpersonal skillsCustomer service mindset
Languages:English
Tech Stack:COBTPLReclamationEOBsHIPAAMicrosoft Excel

Company Brief

Machinify
Provides AI-driven predictive maintenance and asset-monitoring solutions for manufacturing and industrial operations, using IoT sensor data and machine learning to reduce downtime, optimize performance, and extend equipment life.
Industry: Industrial Automation
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