SoTalent ยท 1 day ago
Senior Resolution Analyst
United States
Full-time
Remote
Mid, Senior Level
2+ years expSoTalent is a global leader in healthcare solutions, and they are seeking a Senior Recovery and Resolution Analyst to join their team in a fully remote capacity. This role involves researching, analyzing, and resolving issues within claims and payment systems to support cost reduction initiatives while collaborating with teams to optimize processes and ensure compliance.
Staffing & Recruiting
Responsibilities
Review and document business procedures to ensure accuracy, security, and efficiency
Investigate and resolve claims for healthcare plans, including government and commercial customers
Manage recovery efforts on subrogation claims and related payment processes
Ensure compliance with federal, state, and internal reimbursement and contract policies
Analyze data and apply problem-solving to identify potential savings or process improvements
Collaborate with internal teams to enhance operational workflows and claim resolution procedures
Qualification
Required
High school diploma or GED
Certified Professional Coder (CPC) credential
At least 18 years old
Minimum 2 years of experience auditing or researching claims
At least 1 year of medical coding experience
Familiarity with claims processing systems and healthcare operations
Ability to work full-time during standard business hours, with occasional flexibility as needed
Preferred
Advanced coding certification (CCS or CPMA)
Experience analyzing claims data to identify cost-saving opportunities
Knowledge of Medicaid and Medicare reimbursement methods
Experience with Microsoft Access and Excel for data analysis and reporting
Familiarity with claims management platforms or OPRS systems
Company
SoTalent
At SoTechTalent, we specialise in connecting forward-thinking tech companies with world-class talent.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase