Healthcare Claims Recovery Specialist-Remote

Healthcare Claims Recovery Specialist

Do you enjoy digging into complex healthcare claims, uncovering what caused a payment issue, and finding the path to resolution? We’re looking for an experienced Healthcare Claims Recovery Specialist who brings a well-rounded background in claims, reimbursement, recoveries, provider relations, hospital operations, and Revenue Cycle Management (RCM).

In this role, you’ll use your investigative and analytical skills to identify payment discrepancies, uncover recovery opportunities, and collaborate with healthcare partners to drive meaningful resolutions.

What You’ll Do

• Investigate complex claims, payment discrepancies, overpayments, and reimbursement issues.
• Research and identify payment recovery opportunities and support claims appeals.
• Conduct root cause analysis and help develop effective resolution strategies.
• Partner with hospitals, healthcare providers, payers, third-party administrators (TPAs), and healthcare vendors.
• Collaborate across teams to improve payment accuracy, recovery outcomes, and operational processes.

What You’ll Bring

• Experience in healthcare claims, claims research, payment recovery, appeals, reimbursement, or revenue cycle operations.
• Strong understanding of hospital/facility operations, provider relations, and healthcare claims workflows.
• Proven ability to research and resolve complex claims and payment issues.
• Experience working across providers, hospitals, payers, TPAs, and/or healthcare vendors.
• Strong analytical, investigative, communication, and problem-solving skills.
• Hospital- or facility-based healthcare/revenue cycle experience strongly preferred.

If you’re a curious problem-solver who enjoys getting to the root of complex payment issues and turning research into results, we’d love to hear from you.