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Recovery Data Analyst Job

Full Job Title: Recovery Data Analyst

Job Number: 1801150

Location: Tampa, FL

Date Posted: 5-25-2018

Location: Woodland Center Blvd, Tampa, FL 33634
Department: Operations
Reports to: Manager, Recovery

Performs advanced and in-depth data analysis and provider profiling to determine recovery opportunities for claims that are overpaid due to retroactive member termination, inappropriate coding, duplication of payments, non-authorized services, erroneous contract or fee schedule reimbursement, non-covered benefit(s) and other reasons. Provide recommendations to reduce future occurrences of overpayments.

Essential Functions:
  • Analyzes contractual obligations and identifies/pursues overpayments on claims for various reasons.
  • Prepares detailed analyses on mis-paid claims with complex business requirements and partners with IT resources for data pulls, analysis, and validation.
  • Summarizes information for business partners for review and resolution and provides recommendations on recovery strategies.
  • Monitors progress of overpayment projects and executes on next steps.
  • Develops comprehensive and detailed analyses on erroneous payments in order to support the revenue collection and reconciliation process.
  • Develops simple data queries to generate reports of overpaid claims
Candidate Education:
  • Required: High School or GED
  • Preferred: Bachelor's Degree in a related field or equivalent work experience
Candidate Experience:
  • Required: 3 years of experience in data analysis and business requirements development
  • Required: 3 years of experience in claims processing, claims operations or claims recovery
Candidate Skills:
  • Demonstrated analytical skills
  • Demonstrated interpersonal/verbal communication skills
  • Demonstrated written communication skills
  • Demonstrated problem solving skills
  • Ability to influence internal and external constituents
*LI-JC1

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Last Updated On: 12/9/2015