Reconciliation and Recovery Analyst

+ Operate with intellectual curiosity and critically assess existing processes and procedures to identify opportunities for improvement
+ Summarize and present data outcomes, recommendations, and methodology to Reconciliation and Recovery leadership, E&B leadership, and enterprise stakeholders
+ Analyze large data sets and identify patterns within the defined population to organize the backlog, determine outliers and identify root-causes of membership, payment, or other data discrepancies
+ Determine short and long-term actions to resolve current cases of membership/ payment discrepancies and new ones from reoccurring
+ Understand, validate, and document the business rule(s) to flag membership for reconciliation and/ or premium recovery for a defined population
+ Liaison between department leaders, subject matter experts, Healthfirst finance, etc.
+ Establish job-aids to enable user-correction of membership errors and/or submission of information to the DOH and NYSoH<...