Want to know if this job is worth applying to?
Remote, Oregon, United States
Remote only
Not Available
Lyric is the trusted leader in healthcare decision intelligence. Built on more than 35 years of proven results, Lyric combines responsible AI with clinical, payment, regulatory, and policy expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments while maintaining full control. Today, Lyric supports 200 million lives, with nine of the top 10 U.S. health plans relying on its platform to reduce waste, improve efficiency, and support accurate payments.
Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position.
The Healthcare Collections Analyst is responsible for processing medical insurance claim overpayments that were identified through Lyric’s data mining efforts including but not limited to posting recoveries, processing adjustments and offsets, and conducting collection activities to secure refund checks. The Healthcare Collections Analyst will also participate in validating the overpayments based on policy instructions and claim coding details and will maintain a library that includes instructions for validating specific audit concepts, client specific rules, and system processing instructions. This person may also assist in the identification process and audit concept improvements to ensure the best return for our clients.
ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES
Perform a variety of support and general administration assignments in support of the team including but not limited to data entry, tracking correspondence, generating, stuffing, and mailing letters.
Process overpayments (post provider refunds, adjustments, offsets) requests, prepare notification letters.
Conduct outbound calls to healthcare providers to request payment recovery in a professional, courteous, and respectful manner.
Clearly communicate payment requests, claim details, and supporting information to provider offices.
Collaborate with internal teams to resolve discrepancies or provider questions efficiently.
Review claims for missing or incomplete information, calculate payment, or validation of identified overpayments.
Work under direct supervision with ability to analyze claim issues from identification to resolution and handle basic problems independently while collaborating with senior team member on more complex issues.
Responsible for reviewing and managing outstanding accounts receivable with guidance by operation leader, contacting providers to collect payment, and identifying issues with unpaid accounts.
Understand client specific policies related to claim payments, provider manual and member benefits. Maintain legal compliance by following company policies, client policies, procedures, guidelines, as well as state and federal regulations.
Recognize and report system issues.
Prepare basic internal and external reports by collecting, analyzing, and summarizing information.
Maintain productivity goals and standards set by the department.
Executes functions with focus on accuracy and quality.
Complete special projects as assigned.
REQUIRED QUALIFICATIONS
Minimum of one (1) year experience in administration support or data entry.
High school diploma.
PREFERRED QUALIFICATIONS
One (1) year experience in healthcare claims operations environment.
College degree in role related field.
Excellent communication skills; verbal and written.
Strong MS Office skills (Word, Excel, PowerPoint).
Strong organization and time management.
Ability to work in a fast-paced environment; flexibility to handle multiple priorities.
***The US base salary range for this full-time position is:
The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. ***
Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success.
