Jr. Financial Recovery Analyst

Job description

Essential Duties and Responsibilities include the following: Generate additional income, savings and/or reduce the expenses of Regal Medical Group through recoupment and/or recovery of various programs and products, to include but not limited to: Capitation Deduction: - Audit all capitation deductions submitted by all the health plans on a monthly basis. - Dispute unwarranted capitation deductions for each health plan. - Send overpayments to the provider of service when capitation resulted in duplicate payments. - Collaborate with Quality Control, Audit, and Claims department for any health plan issues and provide resolution. - Collaborate with HPN if credits were received as a result of disputes presented to the health plans. - Ensure Inload of Cap Deducts in EZCAP and entries of recoveries are made. - Act as liaison to the health plan if there are any capitation deduction issues brought by HPN/RMG. - Refer to division head health plan issues or other department concerns that are not within the parameters of the internal procedures we have established on capitation deduction. Lakeside Overpayments: - Recoup from Lakeside overpayments if the HMO coordinator cannot tackle the heavy...