Senior Financial Recovery Analyst

About the role

Proactively assess and monitor vendor operational performance to ensure contractual targets and quality expectations are met. Monitor and support daily financial recovery activities to ensure negative balance claims and identified overpayments are recovered timely and appropriately. Engage directly with Special Handling, Tier 1, and high-exposure non-special handling facilities/providers across the enterprise. Identify improvement opportunities and collaborate with internal and external business partners to develop action plans that resolve issues and prevent future overpayments.

Responsibilities

• Strengthen claims recovery by building and maintaining effective partnerships with Emblem Providers and Provider Network Management to support overpayment identification, collection activity, and direct provider engagement.
• Monitor provider outreach/follow-up activities to ensure timely responses and resolution of identified overpayments.
• Investigate and analyze claim overpayments, review root cause findings with providers, and