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Administrative Project Coordinator, Financial Recovery Unit

EmblemHealth -
New York, NY

Job Details

$48,600 - $83,160 a year

Qualifications

Confidential information handling
Microsoft Outlook
Presentations for conferences or internal meetings
CMS
Regulatory compliance in claims processing
Medical claims processing software
CMS regulatory compliance
Project management experience in healthcare
Microsoft Teams
SharePoint
Managing projects
Cross-functional communication

Full Job Description

REMOTE

Summary of Position

Responsible for managing the manual check workflow, ensuring appropriate documentation, quality review, and reconciliation of recovery payments.
Coordinate key departmental meetings, maintaining agendas, task outlines and task follow-up.
Manage escalated financial recovery issues, and ensure administrative processes operate efficiently and in compliance with regulatory and organizational standards.
Responsible for supporting the operational integrity of financial recovery processes while ensuring administrative coordination, compliance, and effective departmental communication.

Principal Accountabilities

Provide administrative oversight of the manual check process, ensuring submissions meet documentation and approval requirements prior to processing. Conduct quality reviews of manual check requests to confirm accuracy, completeness, and compliance with internal financial recovery procedures.
Research and investigate recovery checks received without supporting documentation to determine appropriate claim attribution and disposition. Work independently to analyze data to identify trends and quality improvement opportunities. Track issues and monitor trends to support their resolution. Identify potential process gaps and document root cause analysis; present findings to management, and work with CTS for resolution.
Support governance and operational initiatives such as Mass Recycle Governance and Negative Balance Improvement efforts by coordinating materials, reporting updates, and monitoring progress against action plans.
Maintain organized records and documentation related to recovery activities, vendor payments, and operational initiatives.
Collaborate with Claims, Finance, Compliance, and Operations teams to ensure alignment on recovery processes and administrative workflows. Serve as key contact to internal and external stakeholders to ensure deadlines are met; provide recommendations for problem resolution; direct/escalate inquiries and issues if needed; ensure proper implementation of needed actions; follow up with appropriate actions to ensure resolution.
Perform active research to prepare and present new ideas to improve current processes which impact the business.
Provide support on all administrative matters, recording meeting minutes and following up on important internal and external meetings; perform reporting and other tasks as needed.
Coordinate and track escalated issues related to financial recoveries, working with internal teams and external partners to ensure timely resolution Process and approve vendor invoices related to recovery operations, ensuring proper documentation, coding, and alignment with contractual agreements
Identify opportunities to improve administrative efficiency and support continuous process improvement within the department.
Perform other duties as assigned or required.

Qualifications

Education, Training, Licenses, Certifications

Bachelor’s degree, preferably in healthcare administration, finance, operations, business administration, or a related field required; Additional years of experience/specialized training may be considered in lieu of educational requirements

Relevant Work Experience, Knowledge, Skills, and Abilities

2 – 3+ years of relevant, professional work experience including positions handling confidential information required
Experience as a project analyst in a related field; strong understanding of project management required

Familiarity with CMS regulations and healthcare payer operational standards required
Proficiency with healthcare claims processing platforms such as FACETS and related operational systems required
Attention to detail; ability to identify and resolve issues; ability to perform data analysis required
Experience in the health care industry preferred
Strong proficiency with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.) required
Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences required
Ability to maintain a calm, professional demeanor, confidentiality, and to effectively complete multiple tasks/projects with competing priority levels and deadlines required

Additional Information

Requisition ID: 1000003109
Hiring Range: $48,600-$83,160

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