Healthcare Reclamation Analyst

Machinify
United States
Workplace: RemoteFull timeUSD 22.5+ hourlyFunction: Healthcare (Clinical, Medical, Wellness)Experience: 2+ yearsEducation: high_schoolSkills: ["Analytical thinking","Communication","Interpersonal skills","Attention to detail","Customer service"]

Review client billing and payer correspondence to determine eligibility, order of benefits, and primacy for coordination-of-benefits (COB) recovery. Investigate discrepancies using COB/TPL/MSP documentation and explanation of benefits (EOBs), communicate with carriers to resolve payment issues, and contact insurance carriers regarding claim responses. Maintain accurate records in company systems, support denial management, and meet productivity and quality metrics while adhering to HIPAA and client compliance requirements.

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FursaFursa
Machinify
Machinify
1 day ago

Healthcare Reclamation Analyst

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 11 hours agoStatus: Live

Job Summary

Review client billing and payer correspondence to determine eligibility, order of benefits, and primacy for coordination-of-benefits (COB) recovery. Investigate discrepancies using COB/TPL/MSP documentation and explanation of benefits (EOBs), communicate with carriers to resolve payment issues, and contact insurance carriers regarding claim responses. Maintain accurate records in company systems, support denial management, and meet productivity and quality metrics while adhering to HIPAA and client compliance requirements.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Mid level

Key Responsibilities

  • •Review assigned client data and payer correspondence to determine eligibility, primacy, and order of benefits and recover funds paid in error.
  • •Investigate data/record discrepancies and resolve issues through research using COB/TPL/MSP documentation and eligibility review.
  • •Communicate with carriers to determine primacy, answer questions, and provide information to drive successful payment or appropriate account action.
  • •Contact healthcare insurance carriers regarding claim responses, educate carriers on COB rules, and respond to complex questions.
  • •Analyze EOBs and written insurance communications, update company systems with accurate contact and account status information, and support denial management while meeting productivity and quality metrics.

Pay and Benefits

Salary: USD 22.5 hourly
Perks:Health InsuranceDentalVisionFsaHsaLearning Budget401kRemote Work

Key Requirements

  • •2+ years of directly relevant progressive experience in billing reclamation or a closely related role applying similar skills and knowledge.
  • •12+ months of relevant collections/accounts receivable experience with consistently high production.
  • •Strong research and analytical skills to gather and interpret explanation of benefits (EOBs) and resolve primacy/order-of-benefits issues.
  • •Applied knowledge of healthcare and medical terminology, preferably with experience in recovery/auditing/research and medical coding.
  • •Demonstrated coordination of benefits (COB), third party liability (TPL), and accounts receivable skills, with the ability to communicate professionally with providers and carriers while following HIPAA standards.
Experience:2+ yearsHealthcareMedical billingAccounts receivableCollectionsHealth planPayer correspondence
Education:High School
Skills:Analytical thinkingCommunicationInterpersonal skillsAttention to detailCustomer service
Languages:English
Tech Stack:Online toolsComputerPhoneHeadset

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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