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Astrana Health · 2 weeks ago

Manager - Claims Revenue Recovery

Monterey Park, CA

Full-time

Hybrid

Mid, Senior Level

$90K/yr - $110K/yr

5+ years exp

Astrana Health is a company focused on healthcare solutions, and they are seeking a Manager - Claims Revenue Recovery. The Revenue & Recovery Claims Manager will oversee daily operations of the claims recovery and revenue integrity team, ensuring accurate claims processing and compliance with recovery procedures.

Health CareMedical

Growth Opportunities

Responsibilities

Lead the claims recovery team in achieving operational goals and recovery targets

Monitor and report on key departmental KPIs, including but not limited to:

Recovery rate

Average claim cycle time

Cost savings and efficiency metrics

Use KPI data to identify trends, gaps, and opportunities for process improvement

Supervise the day-to-day operations of the revenue and recovery claims team, ensuring accuracy, efficiency, and compliance

Monitor claims processing and recovery activities to identify trends, issues, and opportunities for improvement

Ensure proper review, validation, and resolution of claim discrepancies, denials, overpayments, and underpayments

Collaborate with payers, providers, and internal teams to address revenue recovery and reconciliation issues

Develop and implement policies, procedures, and performance standards aligned with organizational goals

Generate and analyze reports to track performance, recovery outcomes, and key metrics

Train, coach, and mentor team members; provide regular feedback and performance evaluations

Support audits, compliance reviews, and reporting requirements related to claims recovery, notices, and revenue integrity

Escalate unresolved or complex issues to management with recommendations for resolution

Foster a positive, collaborative team culture focused on accountability and continuous improvement

Oversee incoming calls from provider offices related to overpayment notices

Other duties as assigned

Qualification

Healthcare claims processingRevenue cycle managementSupervisory experienceClaims systems proficiencyAnalytical skillsMicrosoft Office SuiteLeadership abilitiesCommunication skillsInterpersonal skillsProblem-solving skillsOrganizational skills