Job Description

Job Description

Job Description

Summary

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

Duties and Responsibilities

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

Minimum Job Requirements

• High School Diploma or G.E.D. is required
• Associate’s or Bachelor’s Degree in Business, Healthcare Management, or Technology is preferred
• 1 year + of related work experience in healthcare or data driven environment
• 1 year + experience working with large data files
• Proficiency in Microsoft Office (Excel, Outlook, Word, etc)

Skill and Abilities

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

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