Savings & Recovery Supervisor

Req #:

3287

Job ID:

14746

Job Location:

New York, NY

Zip Code:

10041

Category:

Claims

Agency:

Elderplan

Status:

Regular Full-Time

Office:

Office-based

Salary:

$61,463.13 - $73,755.75 per year

The MJHS Difference

At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness and belonging for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.

Benefits include:

• Tuition Reimbursement for all full and part-time staff
• Generous paid time off, including your birthday!
• Affordable and comprehensive medical, dental and vision coverage for employee and family members
• Two retirement plans! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities:

Provides leadership and supervises the vendor operations, financial processes and staff resources of the Claims Savings & Recovery Unit. Provide oversight to subrogation vendor and subrogation process.  Ensure maximum recovery of subrogation cases. Provide oversight to AIM (vendor) responsible for Par DRG Validation, medical bill audit and credit balance savings.  Ensure maximum recovery of audit cases. Provide oversight to MedReview and Health Information Consulting vendors responsible for DRG validation of non par focused DRG claims and cost outlier review. Provide oversight and coordination of all applicable tax levy and garnishments regulated by Federal and State agencies.  Provide oversight and coordination of all applicable overpayment identified via reports provided via Health Economics.

Qualifications:

• Bachelor's Degree or equivalent combination of education and experience from which comparable knowledge may be acquired, is required.
• 3-5 years coordination, supervisory or management experience
• Previous managed care experience working in a health insurance company
• Knowledge of ICD-10, CPT-4 and DRG coding and medical terminology
• Knowledge of Medicare benefits, reimbursement and federal/state regulations as it pertains to claims processing

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