Schedule: Hybrid schedule - remote work on Monday and Friday, and onsite presence Tuesday through Thursday.



Description:

The Provider Recovery Auditor is responsible for auditing and recovering claims overpayments, including the coordination of benefits (COB) and third-party liability. This role supports organizational quality initiatives and ensures compliance with claims processing guidelines, contractual agreements, and regulatory standards within a managed care environment.

What You Will Do:

• Identify and expand recovery opportunities through audit findings, provider outreach, third-party liability, and CCS eligible services


• Conduct audits of payment errors and process provider refund checks while determining root cause


• Review claims processing outcomes to ensure accuracy and proper a...