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Recovery Audit Jobs (NOW HIRING)

PRGX Global, Inc

Director, Sales

This role focuses on selling PRGX's contract compliance, profit recovery, and Source-to-Pay analytics solutions to senior leaders across Procurement, Finance, Shared Services, and Internal Audit. The ...

EoS Fitness

Wellness & Recovery Specialist

Tempe, AZ · On-site

The Wellness & Recovery Specialist focuses on providing exceptional service by supporting amenities ... Conduct daily audits of equipment functionality and cleanliness during weekly walks for all ...

EoS Fitness

The Wellness & Recovery Specialist focuses on providing exceptional service by supporting amenities ... Conduct daily audits of equipment functionality and cleanliness during weekly walks for all ...

EoS Fitness

The Wellness & Recovery Specialist focuses on providing exceptional service by supporting amenities ... Conduct daily audits of equipment functionality and cleanliness during weekly walks for all ...

EoS Fitness

Wellness & Recovery Specialist

Houston, TX · On-site

The Wellness & Recovery Specialist focuses on providing exceptional service by supporting amenities ... Conduct daily audits of equipment functionality and cleanliness during weekly walks for all ...

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$120.2K

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How much do recovery audit jobs pay per year?

As of Jun 5, 2026, the average yearly pay for recovery audit in the United States is $120,236.00, according to ZipRecruiter salary data. Most workers in this role earn between $104,000.00 and $136,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Recovery Audit position, and why are they important?

To thrive as a Recovery Audit professional, you need a strong background in finance, accounting, data analysis, and attention to detail, often supported by a degree in accounting or a related field. Familiarity with recovery audit software, spreadsheets, and ERP financial systems such as SAP or Oracle is typically required, and certifications like Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) can be advantageous. Strong communication, critical thinking, and problem-solving abilities help build relationships with clients and internal teams while identifying discrepancies. These skills and qualities are vital to ensuring accurate financial recoveries, maintaining compliance, and maximizing organizational profitability.

What is a Recovery Audit job?

A Recovery Audit job involves reviewing financial transactions, payments, and invoices to identify overpayments, duplicate payments, or billing errors. Professionals in this role analyze financial records, reconcile accounts, and ensure compliance with contracts and regulations. They work to recover lost funds for organizations by identifying discrepancies and initiating corrective actions. This role requires strong analytical skills, attention to detail, and knowledge of financial systems and auditing processes. Recovery audit professionals often collaborate with finance teams, vendors, and clients to resolve payment issues efficiently.

What are some typical daily responsibilities of a Recovery Audit professional?

A Recovery Audit professional spends much of their day reviewing transactions, invoices, contracts, and vendor records to identify errors and recover lost revenue. They analyze large data sets, document findings, prepare detailed audit reports, and communicate with both internal departments and external vendors to resolve discrepancies. Additionally, they may participate in process improvement initiatives to help prevent future errors. Collaboration with procurement, accounts payable, and management teams is common, and the role often requires balancing independent analytical work with teamwork to drive successful audit outcomes.

More about Recovery Audit jobs
What are the most commonly searched types of Recovery Audit jobs? The most popular types of Recovery Audit jobs are:
What states have the most Recovery Audit jobs? States with the most job openings for Recovery Audit jobs include:
What job categories do people searching Recovery Audit jobs look for? The top searched job categories for Recovery Audit jobs are:
Recovery Audit jobs near you
Manager, Benefits Coordination and Claims

Manager, Benefits Coordination and Claims

EmblemHealth

New York, NY • Remote

Other

Medical

Posted 14 days ago

Job description

REMOTE

Summary of Position

  • Responsible for leading and optimizing the organization's secondary payer and revenue recovery processes across all lines of business, establishing performance metrics and accountability standards aligned with organizational goals.
     
  • Lead, supervise, and develop a team of COB Specialists, establishing performance metrics and accountability standards aligned with organizational goals
     
  • Ensure accurate identification and management of Other Health Insurance (OHI), compliance with CMS and regulatory requirements, and operational excellence within COB functions.
     
  • Monitor and analyze COB metrics, denial trends, and recovery outcomes; implement process improvements to enhance operational effectiveness.
     
  • Drive strategic initiatives to reduce claim overpayment, improve recovery outcomes, and strengthen financial performance while maintaining regulatory integrity.


Principal Accountabilities

  • Oversee end-to-end COB operations, including identification and validation of Other Health Insurance (OHI), Medicare Secondary Payer (MSP) processing, and commercial coordination rules. Ensure accurate application of Medi Investigate and resolve complex COB claim denials, payment disputes, and escalated provider or member inquiries.
     
  • Ensure accurate application of Medicare, Medicaid, Essential Plan, Exchange, and Commercial Group Health Plan COB rules.
     
  • Ensure full compliance with Centers for Medicare & Medicaid Services (CMS) regulations, including Medicare Secondary Payer (MSP) requirements, and Section 111 quarterly filings.
     
  • Maintain adherence to federal and state COB regulations across all product lines, including Medicaid and Exchange plans.
     
  • Investigate and resolve complex COB claim denials, payment disputes, and escalated provider or member inquiries.
     
  • Identify root cause of issues and work with internal teams to improve processes and close process gaps.
     
  • Collaborate and work cross-functionally with other operational areas (Claims, Provider Network Management, Contract Configuration, Provider File Operations, Payment Integrity, etc.) to ensure root causes are remediated for both overpayment and underpayments.
     
  • Lead internal and external compliance audits and regulatory obligations.
     
  • Implement corrective action plans in response to audit findings, regulatory updates, or compliance reviews.
     
  • Support internal and external audits by maintaining accurate documentation, policies, and standard operating procedures.
     
  • Partner with Claims, Enrollment, Finance, Compliance, and IT to ensure data integrity, accurate eligibility verification, and system optimization.
     
  • Responsible for vendor relationships and recovery audit processes, as applicable.
     
  • Develop and deliver ongoing team training to ensure regulatory updates, policy changes, and system enhancements are effectively implemented.
     
  • Perform other duties as assigned or required.

Qualifications

  • 5 - 8+ years' relevant work experience in claims operations within a health insurance carrier environment required
     
  • Bachelor's degree required; additional experience/specialized training may be considered in lieu of degree
     
  • Demonstrated expertise in Medicare, Medicaid, Essential Plan, Exchange, and Commercial Group Health Plan Coordination of Benefits rules required
     
  • 5+ years' experience managing staff / processes required
     
  • In-depth knowledge of HIPAA regulations and CMS guidelines, including Medicare Secondary Payer requirements required
     
  • Strong understanding of COB investigative processes, overpayment recovery methodologies, and denial management required
     
  • Proficiency with claims processing platforms such as Facets and related eligibility and enrollment systems required
     
  • Advanced analytical skills with the ability to interpret claims data, identify trends, and implement corrective strategies required
     
  • Excellent communication and leadership skills with the ability to drive accountability and cross-functional collaboration required
     
  • Strong organizational and auditing skills and attention to detail with a focus on operational efficiency and compliance integrity required
     
  • Ability to effectively organize, prioritize, and manage multiple tasks/projects with simultaneous conflicting deadlines required
     
  • Strong analytic, decisionmaking, and problemsolving abilities required
     
  • Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.) required
     
  • Demonstrated leadership skills in a matrix environment required
     
  • Ability to discern and identify patterns/trends of issues and provide recommendations for resolution required
Additional Information
  • Requisition ID: 1000003153
  • Hiring Range: $77,760-$149,040

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