Recovery Specialist - Palm Desert, United States - Desert Oasis Healthcare

Desert Oasis Healthcare
Desert Oasis Healthcare
Verified Company
Palm Desert, United States

3 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

The Finance Recovery Specialist is responsible for the design, development and maintenance of the processes to maximize recovery of amounts due to DOHC and AZPC (and/or minimize incorrect/inappropriate expenditures) as a result of Claims activities, including but not limited to refund of payments made in error to providers, retro terms, HP cap deducts, erroneous provider billings and focused Vendor audits.

The Finance Recovery Specialist will oversee third party vendors who manage provider recoveries and/or third-party liability recoveries.

The Finance Recovery Specialist will partner with other members of the DOHC team to obtain necessary information and build reporting to efficiently manage these processes.


  • Work with HP information to ensure capitation deductions are appropriate and accurately paid and followup on disputes with HP.
  • Review CMS Hospice report and recover claims leakage.
  • Manage TPL and WC recovery vendor process to ensure maximum recovery.
  • Manage DOHC insured services recoveries.
  • Identify claim leakage for retro terms and recover from vendor/providers appropriately.
  • Followup on any claims identified refund request to ensure full recovery.
  • Place claim filing for unclaimed payments in California and Arizona.
  • Company will provide DOHC laptop to be used at home: Employee will ensure adequate internet and cellular communication available at employee's expense at telecommute location.
  • Perform other duties as assigned.
(10658)

  • High School diploma. Bachelor's degree, preferred.
  • 5 years of experience in recovery management.
  • Knowledge of HP DOFR's, claims work flow and data compilation and review
  • Demonstrated expertise in use of MS Office, including Excel and Word.
  • At the discretion of DOHC/FHC management, this position has the potential to be a full or hybrid telecommuting position.
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