Manager - Claims Revenue Recovery at Astrana Health

Department: Ops - Claims Ops

Location: 1600 Corporate Center Dr., Monterey Park, CA 91754

Compensation: $90,000 - $110,000 / year

Description

Job Title: Manager - Claims Revenue Recovery
Department: Ops - Claims Ops

The Revenue & Recovery Claims Manager is responsible for overseeing the daily operations of the claims recovery and revenue integrity team. This role ensures accurate processing of claims, identification of recovery opportunities, compliance with regulatory and contractual recoupment procedures, and effective resolution of discrepancies. The Manager provides leadership, guidance, and performance management for staff while partnering with internal departments and external stakeholders to optimize revenue and minimize financial risk. Work Environment: • Hybrid work setting, with potential need to attend meetings onsite.

What You'll Do

• Lead the claims recovery team in achieving operational goals and recovery targets
• Monitor and report on key departmental KPIs, including but not limited to:
  • Recovery rate
  • Average claim cycle time
  • Cost savings and efficiency metrics
• Use KPI data to identify trends, gaps, and opportunities for process improvement
• Supervise the day-to-day operations of the revenue and recovery claims team, ensuring accuracy, efficiency, and compliance
• Monitor claims processing and recovery activities to identify trends, issues, and opportunities for improvement
• Ensure proper review, validation, and resolution of claim discrepancies, denials, overpayments, and underpayments
• Collaborate with payers, providers, and internal teams to address revenue recovery and reconciliation issues
• Develop and implement policies, procedures, and performance standards aligned with organizational goals
• Generate and analyze reports to track performance, recovery outcomes, and key metrics
• Train, coach, and mentor team members; provide regular feedback and performance evaluations
• Support audits, compliance reviews, and reporting requirements related to claims recovery, notices, and revenue integrity
• Escalate unresolved or complex issues to management with recommendations for resolution
• Foster a positive, collaborative team culture focused on accountability and continuous improvement
• Oversee incoming calls from provider offices related to overpayment notices
• Other duties as assigned
  
  

Qualifications

Education:

• Bachelor’s degree in healthcare administration, business, finance, or related field (or equivalent experience)

Experience:

• 5-7 years in healthcare claims, revenue cycle, or recovery operations
• At least 4 years in a supervisory or team lead role

Knowledge/Skills:

• Strong understanding of healthcare claims processing, reimbursement methodologies, and regulatory requirements
• Familiarity with payer contracts, denials management, and revenue recovery strategies
• Proficiency with claims systems, reporting tools, and Microsoft Office Suite (Excel, Word, Outlook)
• Excellent analytical, organizational, and problem-solving skills
• Strong leadership, communication, and interpersonal abilities

You're great for this role if:

• You thrive on solving problems and turning complex claims issues into clear resolutions
• You enjoy leading and developing people, helping them grow while keeping the team focused on results
• You’re detail-oriented and analytical, but can also see the “big picture” when it comes to revenue cycle impact
• You communicate clearly and confidently—whether you’re collaborating with your team, explaining data, designing letter templates. or addressing payers and providers
• You’re adaptable and embrace change as an opportunity to improve processes and outcomes
• You take accountability, and display ownership of results and find satisfaction in driving efficiency, accuracy, and recovery success
  
  

Environmental Job Requirements and Working Conditions

• Our organization follows a hybrid work structure where expectation is to work both in office and at home on a weekly basis and or with potential need to attend meetings onsite. The office is located at 1600 Corporate Center Drive, Monterey Park, CA 91754
• The total compensation target pay range for this role is: $90,000 - $110,000. The salary range represents our national target range for this role.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] request an accommodation.

Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change