Recovery Analyst

Lyric, formerly ClaimsXten, is a leading healthcare technology company, committed to simplifying the business of care. Over 30 years of experience, dedicated teams, and top technology help deliver more than $14 billion of annual savings to our many loyal and valued customers—including 9 of the top 10 payers across the country. Lyric’s solutions leverage the power of machine learning, AI, and predictive analytics to empower health plan payers with pathways to increased accuracy and efficiency, while maximizing value and savings. Lyric’s strong relationships as a trusted ally to customers resulted in recognition from KLAS as “true partner” and “excellent value for investment,” with a top score for overall customer satisfaction and A+ likelihood to recommend in their October 2023 Payment Integrity and Accuracy Report. Discover more at Lyric.ai. 

Job Summary:

The Recovery Analyst is responsible for processing medical insurance claim overpayments that were identified through Lyric’s data mining efforts including but not limited to posting recoveries, processing adjustments and offsets, and conducting collection activities to secure refund checks. The Recovery Analyst will also participate in validating the overpayments based on policy instructions and claim coding details and will maintain a library that includes instructions for validating specific audit concepts, client specific rules, and system processing instructions.

• Perform a variety of general administration assignments in support of the team including but not limited to data entry, tracking correspondence, generating, stuffing, and mailing letters

• Process overpayments (post provider refunds, adjustments, offsets) requests, prepare notification letters

• Review claims for missing or incomplete information, calculate payment, or validation of identified overpayments

• Work under direct supervision with ability to analyze claim issues from identification to resolution and handle basic problems independently while collaborating with senior team member on more complex issues

• Responsible for reviewing and managing outstanding accounts receivable with guidance by operation leader, contacting providers to collect payment, and identifying issues with unpaid accounts

• Understand client specific policies related to claim payments, provider manual and member benefits. Maintain legal compliance by following company policies, client policies, procedures, guidelines, as well as state and federal regulations.

• Recognize and report system issues

• Prepare basic internal and external reports by collecting, analyzing, and summarizing information.

• Maintain productivity goals and standards set by the department

• This role may also assist in the identification process and audit concept improvements to ensure the best return for our clients

• Complete special projects as assigned

***The US base salary range for this full-time position is:

The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. ***

Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success.