Job Description

Job Description

Under the guidance of the Auditing & Recoveries Manager & Supervisor, the Financial Recovery Data Analyst is responsible for overlooking the OB Maternity Kick agreements for MPMs Hospital & IPA clients. This includes submitting, tracking & reconciling deliveries.

Duties and Responsibilities

1. Prepare monthly reporting for OB Kick
2. Run authorization & claim reports to identify potential delivery cases
3. Research & confirm livebirth deliveries
4. Submit and track deliveries
5. Follow specific submission instructions for each plan
6. Update tracking sheets and apply corresponding rates
7. Monitor payments being received
8. Post payments and calculate outstanding amounts
9. Send tracking updates to the IPA/Hospital Analysts
10. Review payments and adjustments for accuracy
11. Reconcile outstanding deliveries and incorrect adjustments
12. Research & compile supporting documentation
13. Submit appeals to the health plans
14. Track correspondence & follow up as needed
15. Annotate tracking and remove expected amounts for ineligible deliveries
16. Coordinate with AR, Claims, Contracting, DOFR, Eligibility & Hospital Ops teams
17. Respond to internal & external requests as needed
18. Cross training on other responsibilities of the Sr. Financial Recovery Data Analyst

Minimum Job Requirements

1. High School Diploma or G.E.D. is required
2. Associates or Bachelors degree in Business, Healthcare Management, or Technology is preferred
3. 1 year + of related work experience in healthcare or data driven environment
4. 1 year + experience working with large data files
5. Proficiency in Microsoft Office (Excel, Outlook, Word, etc)

Skills and Abilities

1. Excellent written & verbal communication skills
2. Strong analytical & critical thinking
3. Ability to multi-task while maintaining a high standard of work
4. Technological literacy

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