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 MPM’s Hospital & IPA clients. This includes submitting, tracking & reconciling deliveries.
Duties and Responsibilities
· Prepare monthly reporting for OB Kick
o Run authorization & claim reports to identify potential delivery cases
o Research & confirm livebirth deliveries
· Submit and track deliveries
o Follow specific submission instructions for each plan
o Update tracking sheets and apply corresponding rates
· Monitor payments being received
o Post payments and calculate outstanding amounts
o Send tracking updates to the IPA/Hospital Analysts
o Review payments and adjustments for accuracy
· Reconcile outstanding deliveries and incorrect adjustments
o Research & compile supporting documentation
o Submit appeals to the health plans
o Track correspondence & follow up as needed
o 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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