Kern Family Health Care · 1 day ago
Claims Revenue Recovery Analyst - Hybrid/Remote
Bakersfield, CA
Full-time
Hybrid
Mid Level
$28.62/hr - $36.49/hr
4+ years expKern Family Health Care is seeking a Claims Revenue Recovery Analyst to assist in the recovery of overpayments. The role involves processing refunds, maintaining logs, and coordinating with finance to ensure the accuracy of recoveries.
Health CareHospitalNon Profit
No H1B
Responsibilities
Credit sheets and credit letters to accounting
Accounting Logs / Check Logs
Prepare advances for accounting and apply refund checks to those advances
Take EOP vendor calls and assist with EOP questions
Provider calls regarding recovery requests
Prepare return check letters
Post all refund checks received
Provider disputes related to recoveries
Recovery letters and follow up
Follow up calls on non-par providers with outstanding recovery request
Process recovery claims in claims system
Refund checks pertaining to TPL
Notify Senior Support Staff regarding other potential liability (TPL) for notification to be sent to State (DHS)
Review negative balance accounts and contact providers for recovery
Identify provider billing error trends and report this to supervisor or manager
Work with Finance and Corporate Services on return mail/checks regarding provider payments
Handel all refund checks received for supplemental payments including but not limited to GEMT and Prop 56
Process claims related to reprocessing projects
Work with finance on HFI Medicare recoveries
Review weekly report for claim processed for EOB when member does not have medical coverage
Perform other job-related duties as required
Adheres to all company policies and procedures relative to employment and job responsibilities
Qualification
Required
High school diploma from an accredited school or equivalent
Minimum of four (4) years of medical claim payment or medical billing processing experience required
Preferred
two (2) years' experience performing claims review for error tracking
Company
Kern Family Health Care
Kern Health Systems, known as Kern Family Health Care, was established in 1993 as a managed care health plan, and is the largest health plan in Kern County.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Emily Duran
Chief Executive Officer
Alan Avery
Chief Operating Officer
Recent News
2025-01-07
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