Remote Recovery Analyst: Claims Overpayments

Centene Corp.; Northern (KY); Hybrid; USD 55,000 - 85,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off + holidays

Flexible work setup (remote/hybrid/ons

Field or office options

Job summary

Centene Corp. is seeking a Recovery Analyst to identify, research and investigate potential claims overpayments, supporting the Claims Recovery function. The role is remote from home anywhere in the United States and requires at least one year of claims processing experience.

Qualified candidates will hold an undergraduate degree or equivalent experience and will work with providers and outsourced vendors to recover overpayments, with regular reporting and data extraction to identify exposure.

Qualifications

• Undergraduate degree or equivalent experience.
• Minimum one year of claims processing experience.
• Ability to work remotely and manage responsibilities independently.

Responsibilities

• Identifies, researches and investigates possible claims overpayments from reports.
• Determines compliance with benefit plans, provider contracts, and policies and procedures.
• Summarizes research results to pursue overpayments from providers.
• Interacts with providers and outsourced vendors to collect overpayments.
• Prepares reports by extracting data to identify further exposure.
• Sends follow-up letters and monitors cash receipts.
• Works with claims adjustment team to reconcile errors when needed.
• Performs other duties as assigned.

Skills

Claims processing

Research

Data extraction

Education

Undergraduate degree

Job description

Centene Corp. is seeking a Recovery Analyst to identify, research and investigate potential claims overpayments, supporting the Claims Recovery function. The role is remote from home anywhere in the United States and requires at least one year of claims processing experience.

Qualified candidates will hold an undergraduate degree or equivalent experience and will work with providers and outsourced vendors to recover overpayments, with regular reporting and data extraction to identify exposure.