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Healthcare Overpayment Recovery Analyst Jobs (NOW HIRING)

Delta-Denta

Operations Analyst

Providence, RI · On-site

Performs the overpayment recovery process to recoup overpayments made to the dentists. * Interact regularly with Customer Service to answer claim-related questions. Data Analysis and Reporting

ADP, Inc.

Operations Analyst

Providence, RI · On-site

Performs the overpayment recovery process to recoup overpayments made to the dentists. * Interact regularly with Customer Service to answer claim-related questions. Data Analysis and Reporting

Careoregon

Payment Integrity Analyst

Review vendor overpayment suggestions for accuracy, adherence to scope, claim recovery activities ... Certification Experience performing statistical claims analysis in a managed care or health care ...

CareOregon, Inc.

Payment Integrity Analyst

Oregon, WI · On-site

Review vendor overpayment suggestions for accuracy, adherence to scope, claim recovery activities ... Performing statistical claims analysis in a managed care or health care setting. * Clinical coding ...

The Phia Group, LLC

Data Engineer (Remote)

$117K - $140K/yr

... of health care cost containment techniques offering comprehensive consulting services, plan ... overpayment recovery, claim negotiation, plan defense, designed to control costs and protect plan ...

Worldpac

Freight Audit & Invoice Manager

Oak Brook, IL

$66K - $88K/yr

The Freight Audit & Invoice Manager leads the Invoice Audit Analyst and owns the systems, processes ... Track recovery amounts by carrier and report on overpayment trends to leadership * Maintain a ...

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How much do healthcare overpayment recovery analyst jobs pay per year?

As of Sep 13, 2026, the average yearly pay for healthcare overpayment recovery analyst in the United States is $91,840.00, according to ZipRecruiter salary data. Most workers in this role earn between $71,500.00 and $107,500.00 per year, depending on experience, location, and employer.

What are popular job titles related to Healthcare Overpayment Recovery Analyst jobs?

For Healthcare Overpayment Recovery Analyst jobs, the most frequently searched job titles are:

Infographic showing various Healthcare Overpayment Recovery Analyst job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 67% Full Time, 14% Part Time, and 17% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $91,840 per year, or $44.2 per hour.

Benefits Coordination and Recovery Specialist

New York, NY • On-site

EmblemHealth
Insurance Services • 1 - 5K employees
Learn more about EmblemHealthexternal

$56K - $99K/yr

Full-time

Medical

Re-posted 10 days ago

Key responsibilities

  • Investigate coordination of benefits and other party liability issues to determine member liability insurance information.

  • Update the claims system with correct COB flags, coverage details, and policy terms to ensure accurate claims processing.

  • Identify, calculate, and recover overpayments related to COB inaccuracies and resolve related issues.

EmblemHealth rating

9.4

Company rating: 9.4 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

REMOTE
Summary of Position
  • Responsible for investigating common and complex coordination of benefits and other party liability issues, determining, and updating member liability insurance information to ensure accurate claims adjudication.
  • Identify primary vs. secondary payer order for Commercial, Medicare, and Medicaid lines of business.
  • Update the claims system with correct COB flags and recovering overpayments related to COB inaccuracies.
  • Communicate with members, insurance carriers, employer groups, and CMS for clarification and resolution.

Principal Accountabilities
  • Research and analyze member eligibility data from multiple sources including internal systems, phone calls to members/providers, CMS, and other carriers to determine correct payer order (primary, secondary, or tertiary).
  • Accurately update the claims system (e.g., Facets, QNXT) with COB flags, coverage details and policy terms to ensure compliant and accurate future claims processing.
  • Conduct mandatory investigations to identify "Working Aged," "Disability," and "End-Stage Renal Disease (ESRD)" status
  • Identify, calculate, and initiate recovery of COB-related overpayments
  • Interface with the Benefits Coordination & Recovery Center (BCRC) and update the Common Working File (CWF) to ensure the global Medicare record accurately reflects other health insurance (OHI).
  • Identify and resolve "conditional payments" that were not paid correctly
  • Maintain a deep understanding of, and strictly adhere to regulatory compliance standards including, COB rules, state/federal regulations, and guidelines for Medicare, Medicaid, and Commercial insurance.
  • Research and correct CMS submission errors and fallout to ensure primacy is set correctly and coverage changes are submitted to CMS on a timely basis in accordance with quality and compliance standards.
  • Trouble-shoot and identify system issues; highlight potential solutions to leadership and document findings.
  • Identifies, fixes and eliminates any "coordination of benefits" issues that are inaccurate or incomplete.
  • Initiate professional communication with providers, insurance carriers, and members to verify coverage information and resolve coordination inquiries.
  • Interface with the Benefits Coordination & Recovery Center (BCRC) and update the Common Working File (CWF) to ensure the global Medicare record accurately reflects other health insurance (OHI).
  • Maintain detailed, accurate, and timely documentation of investigation results and recovery activities in company databases.
  • Assist in the collection and validation of data required for Section 111 of the MMSEA, ensuring accurate member records are transmitted to CMS to avoid civil monetary penalties.
  • Maintain detailed documentation of COB investigations to satisfy CMS "Pay and Chase" audits and Medicaid Third Party Liability (TPL) requirements.
  • Oversee "crossover" claim processes in accordance with COBA standards, ensuring supplemental and secondary claims are transmitted to the correct payers without duplication.
  • Perform other duties as assigned or required.

Qualifications
Education, Training, Licenses, Certifications
  • Bachelor's degree in healthcare administration or related field required; additional experience/specialized training may be considered in lieu of degree

Relevant Work Experience, Knowledge, Skills, and Abilities
  • 3 - 5+ year of experience in health insurance claims, COB investigation, claims recovery, or payment integrity required
  • Solid understanding of COB investigative methodologies, overpayment recovery processes, and denial resolution required
  • Proficiency with claims processing systems such as Facets and related eligibility and enrollment platforms required
  • Strong written and verbal communication skills with the ability to effectively partner with regulatory agencies and external insurers required
  • Detail-oriented with a focus on operational accuracy, compliance integrity, and overpayment prevention required
  • Ability to manage multiple complex cases simultaneously in a fast-paced environment required
  • Strong analytic, decision-making, and problem-solving abilities required
  • Strong investigative skills, with proven ability to gather and interpret Explanation of Benefits (EOB), including use of online payer portals, answer questions and resolve standard as well as complex issues with payments required
  • Ability to follow policy, procedures, and regulations in the workplace, and demonstrates ability to lead by example and support development of junior team members required
  • Ability to effectively perform work independently and work cooperatively with others to promote a positive team environment required
  • Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.) required

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