Claims Recovery Analyst I

Job description

**This role is available remotely in Washington State Only. Who we are: Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: - Strive to a pply an equity lens to all our work. - Reduce health disparities. - Create an equitable work environment. About the Role: Responsible for conducting focused claim reviews and identifying and facilitating claim adjustments based on results found through Community Health Plan of Washington claim reviews or as identified by internal Community Health Plan of Washington departments. Responsible for sustaining processes and executing process improvement and quality monitoring. Responsible for contacting providers regarding negative balance collections. Additionally, the role involves investigating and resolving escalated claims issues raised by internal Community Health Plan of Washington (CHPW) departments and committees. The incumbent monitors departmental compliance with state and CMS requirements, i...