Recovery Analyst

CVS Health

Recovery Analyst managing allocation and recovery of overpaid dollars for CVS Health. Collaborating with vendors and internal teams to ensure compliance and effective communication.

Posted 4/28/2026full-timeRemote • Idaho, Minnesota, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $19 - $42 per hourWebsite

About the role

Key responsibilities & impact

Pursue the recovery and allocation of overpaid dollars, and non-routine and complex refunds
Manage, monitor, and work overpayment items
Partner with third-party vendors, research and respond to recovery inquiries
Make outbound calls to providers; track and conduct follow-ups to recover funds
Collaborate with key business functions on escalated overpayments to coordinate recovery efforts
Review, collect, and resolve overpay or recovery conflicting, missing or inaccurate information via telephone or written correspondence
Partner with internal customers/business units, third party vendors, and liaisons to recover and fully allocate refunds
Administer overpayment recovery policy and procedures, telephone and written correspondence to members, providers, and other insurers
Manage overpayment work; collaborate and conduct provider outreach to achieve business goals
Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures
Use a systematic approach in solving problems through analysis and evaluation of alternate solutions
Utilize available reports to track inventory and recovery results
May deliver recovery training programs for less experienced team members
Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise
Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process
Performs medical claim re-work calculations
Process complex non-routine Provider Refunds and Returned Checks
Review and interprets medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks
Utilize all resource materials to manage job responsibilities

Requirements

What you’ll need

3+ years of medical claims processing experience
2+ years of medical claims adjustments and/or rework experience
2 years of experience working in a fast-paced, deadline-driven, high-volume environment
Experience conducting outbound calls, including provider outreach
Experience handling customer service inquiries via phone and/or written correspondence
Ability to interpret and apply guidelines related to eligibility, coverage, and benefits
Demonstrated ability to manage multiple assignments with a high degree of accuracy and attention to detail

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources, based on eligibility

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical claims processingclaims adjustmentsclaims reworkoverpayment recoveryeligibility verificationcost containment measuresprovider contract interpretationrefund allocationproblem solvingdata analysis

Soft Skills

attention to detailcommunicationcollaborationcustomer servicetime managementorganizational skillstrainingoutbound callingmulti-taskingadaptability