Healthcare Reclamation Analyst

The Healthcare Reclamation Analyst reviews client data and payer correspondence to investigate coverage, determine eligibility and primacy, and gather and interpret explanation of benefits (EOBs) and payer feedback to recover funds for clients who have paid in error. This role requires a solid knowledge of COB/TPL/Recovery to gather and review in-house data with payer correspondence to determine the proper order of benefits and resolve primacy issues. The analyst must effectively communicate with carriers to determine primacy, educate them on Coordination of Benefits rules, and analyze written communications from insurance companies. They will also support internal groups with gathering and interpretation of the claims billing process and denial management. This position demands adherence to company policies, HIPAA standards, and client requirements, while consistently meeting productivity metrics. A high school diploma with 2 years of billing reclamation or related experience is required, with relevant college courses or certification being a plus.