Job Summary
This position plays a vital role in enhancing payment integrity through the analysis and creation of post-payment recovery strategies and claims adjustments. The analyst will convert research outcomes into comprehensive business specifications that guide technical teams in implementation.
Responsibilities
- Research and develop concepts related to post-payment recovery.
- Create claims edits to optimize payment integrity processes.
- Translate analytical findings into detailed business requirements for technical teams.
Qualifications
- Minimum 2 years of experience in managed care or health insurance.
- Strong analytical and problem-solving capabilities.
- Proficient in medical coding and reimbursement methodologies.
- Preferred professional certifications in relevant fields.
Molina Healthcare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
