About the Role
Title: Recovery Analyst
Location: -US
Job Description:
Lyric, formerly ClaimsXten, is a leading healthcare technology company, committed to simplifying the business of care. Over 30 years of experience, dedicated teams, and top technology help deliver more than $14 billion of annual savings to our many loyal and valued customers-including 9 of the top 10 payers across the country. Lyric’s solutions leverage the power of machine learning, AI, and predictive analytics to empower health plan payers with pathways to increased accuracy and efficiency, while maximizing value and savings. Lyric’s strong relationships as a trusted ally to customers resulted in recognition from KLAS as “true partner” and “excellent value for investment,” with a top score for overall customer satisfaction and A+ likelihood to recommend in their October 2023 Payment Integrity and Accuracy Report. Discover more at Lyric.ai.
Job Summary:
The Recovery Analyst is responsible for processing medical insurance claim overpayments that were identified through Lyric’s data mining efforts including but not limited to posting recoveries, processing adjustments and offsets, and conducting collection activities to secure refund checks. The Recovery Analyst will also participate in validating the overpayments based on policy instructions and claim coding details and will maintain a library that includes instructions for validating specific audit concepts, client specific rules, and system processing instructions.
- Perform a variety of general administration assignments in support of the team including but not limited to data entry, tracking correspondence, generating, stuffing, and mailing letters
- Process overpayments (post provider refunds, adjustments, offsets) requests, prepare notification letters
- Review claims for missing or incomplete information, calculate payment, or validation of identified overpayments
- Work under direct supervision with ability to analyze claim issues from identification to resolution and handle basic problems independently while collaborating with senior team member on more complex issues
- Responsible for reviewing and managing outstanding accounts receivable with guidance by operation leader, contacting providers to collect payment, and identifying issues with unpaid accounts
- Understand client specific policies related to claim payments, provider manual and member benefits. Maintain legal compliance by following company policies, client policies, procedures, guidelines, as well as state and federal regulations.
- Recognize and report system issues
- Prepare basic internal and external reports by collecting, analyzing, and summarizing information.
- Maintain productivity goals and standards set by the department
- This role may also assist in the identification process and audit concept improvements to ensure the best return for our clients
- Complete special projects as assigned
Required Qualifications:
- 1 year experience in administration support or data entry
- High school diploma
- Excellent communication skills, including both verbal and written
- Strong MS Office skills (Word, Excel, PowerPoint)
- Strong organization and time management
- Ability to work in a fast-paced environment; flexibility to handle multiple priorities
Preferred Qualifications:
- 1 year experience in healthcare claims operations environment
- College degree in related field