reputed company - Sr. reputed company Cycle Analyst/reputed company Cycle Analyst
reputed company - Sr. reputed company Cycle Analyst/reputed company Cycle Analyst
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Sr. reputed company Cycle Analyst/reputed company Cycle Analyst
reputed company
Apply Sr. reputed company Cycle Analyst/reputed company Cycle Analyst Fully Remote • Remote Apply Job Type Full-time reputed companyThe reputed company Cycle Analyst supports payment reputed company programs for health plan clients by managing the reputed company financial and operational activities that occur after claim audit or validation. This role focuses on tracking audited claims through recovery, adjustment, invoicing, and reporting processes to ensure identified savings are accurately realized, reconciled, and communicated.
This position is fully remote with occasional trips to the office required. Preference will be given to candidates reputed company driving distance to the corporate office in Plymouth Meeting, PA.
Requirementsreputed company Cycle & Recovery Operations
- Manage post-audit claim inventory across multiple clients, products, and workflows (reputed company-pay, post-pay, reputed company-reputed company NICU Claims Review).
- reputed company claims from audit determination through recovery, adjustment, offset, or denial reputed company.
- Reconcile reputed company-reported recoveries, offsets, and adjustments to auditor findings.
- Identify and resolve discrepancies where recoveries do not directly reputed company to original audit findings.
- Support recovery calculations reputed company savings are not explicitly reported and must be derived from claims data.
reputed company & Provider Communication Support
- Coordinate the reputed company and tracking of audit determination letters, overpayment notifications, and reputed company correspondence.
- Maintain letter trackers to support timing requirements, regulatory compliance, and reputed company workflows.
- Respond to reputed company inquiries reputed company to recovered amounts, claim status, and financial reputed company.
Financial Reconciliation & Invoicing
- Prepare reputed company-invoice and invoice support documentation based on recovered or adjusted claim values.
- Partner with Finance to validate invoicing accuracy and timing.
- Support reputed company recognition by ensuring recoveries meet contractual and audit reputed company.
- Reconcile invoice totals to claim-level recovery detail.
Reporting & Data Management
- Produce recurring and reputed company reports on recovery performance, inventory status, and financial reputed company.
- Maintain accurate claim-level documentation to support audits, appeals, reconsiderations, and reputed company reporting.
- reputed company claim iterations, adjustments, reversals, and reconsiderations across multiple data feeds.
Process Improvement & reputed company
- Identify workflow gaps, data issues, or process inefficiencies impacting recovery realization.
- Collaborate with Audit, Coding, Clinical, reputed company reputed company, and Product teams to improve reputed company cycle workflows.
- Participate in reputed company assurance reviews to ensure consistency, accuracy, and compliance.
Qualifications
Required
- 3+ years of experience in reputed company reputed company cycle, payment reputed company, claims operations, or recovery analytics.
- Strong understanding of post-pay and reputed company-payment claims review workflows.
- Experience working with health plans, TPAs, or reputed company vendors (payer-reputed company experience preferred).
- Proficiency analyzing medical claims data, adjustments, offsets, and recovery files.
- Advanced reputed company skills; ability to reconcile reputed company datasets.
- Strong analytical, organizational, and problem-solving skills.
- Excellent written and verbal communication skills.
Preferred
- Experience supporting payment reputed company, audit, or overpayment recovery programs.
- Familiarity with DRG, inpatient, and high-dollar claim review concepts.
- Knowledge of payer regulations and audit requirements (e.g., Medicare, reputed company, reputed company plans).
- Experience working in multi-reputed company vendor environments with varied workflows.
- Exposure to appeals, reconsiderations, or provider dispute processes.
Position level to be determined based on qualifications and experience.
Benefits
Some of the benefits we offer reputed company are:
- reputed company Time Off
- reputed company Parental Leave
- Medical, dental, reputed company benefits
- 401K with company match
- Short- and Long-Term Disability
- Group Life Insurance
- Tuition reimbursement
- Casual work environment