Manager Claims Recovery

CommonSpirit Health • Bakersfield, CA

9d

About The Position

The Claims Recovery Manager is responsible for leading the recovery operations within the MSO Claims department. This role oversees all efforts to identify, validate, and recoup overpayments, as well as enhance controls to prevent future payment errors. The Recovery Manager works in close coordination with internal audit, provider dispute resolution, and finance to maximize cost recovery, reduce payment errors, and support contractual compliance.

Requirements

• High School Graduate or GED
• Minimum 5 years of progressive experience in healthcare claims recovery, payment integrity, or post-payment audit functions, preferably within a multi-plan MSO or delegated entity.
• Minimum 2 years of people management or team leadership experience.
• Strong working knowledge of managed care contracts, provider reimbursement methodologies, and recovery-related policies (e.g., COB, TPL, retro reviews).
• Proficiency in Microsoft Excel; familiarity with claims adjudication platforms (e.g., QNXT, EZCAP).

Nice To Haves

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field or equivalent work experience.
• Experience managing vendor recovery relationships or large-scale recovery initiatives.
• Familiarity with audit tools, denial management, and provider relations workflows
• Knowledge of Medicare Advantage, Commercial, and Medi-Cal managed care recovery requirements.

Benefits

• competitive pay
• Health & Welfare benefits package
• medical, dental and vision plans
• Health Spending Account (HSA)
• Life Insurance and Long Term Disability
• 401k retirement plan with a generous employer-match
• Paid Time Off and Sick Leave

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees