Healthcare Collections Analyst

The Healthcare Collections Analyst is responsible for processing medical insurance claim overpayments that were identified through Lyric’s data mining efforts, including but not limited to posting recoveries, processing adjustments and offsets, and conducting collection activities to secure refund checks. The analyst will also validate the overpayments based on policy instructions and claim coding details, maintain a library of instructions for validating specific audit concepts, client specific rules, and system processing instructions, and may assist in identifying audit concept improvements to ensure the best return for our clients. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES Perform a variety of support and general administration assignments in support of the team including but not limited to data entry, tracking correspondence, generating, stuffing, and mailing letters. Process overpayments (post provider refunds, adjustments, offsets) requests, prepare notification letters. Conduct outbound calls to healthcare providers to request payment recovery in a professional, courteous, and respectful manner. Clearly communicate payment requests, claim details, and supporting information to provider offices. Collaborate with internal teams to resolve discrepancies or provider questions efficiently. Review claims for missing or incomplete information, calculate payment, or validate identified overpayments. Work under direct supervision with ability to analyze claim issues from identification to resolution and handle basic problems independently while collaborating with senior team member on more complex issues. Responsible for reviewing and managing outstanding accounts receivable with guidance by operation leader, contacting providers to collect payment, and identifying issues with unpaid accounts. Understand client specific policies related to claim payments, provider manual and member benefits. Maintain legal compliance by following company policies, client policies, procedures, guidelines, as well as state and federal regulations. Recognize and report system issues. Prepare basic internal and external reports by collecting, analyzing, and summarizing information. Maintain productivity goals and standards set by the department. Execute functions with focus on accuracy and quality. Complete special projects as assigned.

REQUIRED QUALIFICATIONS

Minimum of one (1) year experience in administration support or data entry. High school diploma.

PREFERRED QUALIFICATIONS

One (1) year experience in healthcare claims operations environment. College degree in role related field. Excellent communication skills; verbal and written. Strong MS Office skills (Word, Excel, PowerPoint). Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. #J-18808-Ljbffr Lyric