Financial Operations Recovery Specialist II
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Indianapolis • Florida, Ohio • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
About the role
- responsible for the discovery, validation, recovery, and adjustments of claims overpayments and claim corrections
- Reviews and validates PrePayment claims for potential savings opportunities using various techniques including systems-based queries, specialized reporting and/or other research
- Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other research
- Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies
- Works closely with staff from other departments on a regular basis to ensure customer satisfaction
- Works closely with contract managers to identify and correct contractual issues when applicable
- May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable processes and all other cash applications as required
- Researches voluntary refunds for accuracy
- Requires accurate balancing of all accounts
Requirements
- Requires a H.S. diploma or equivalent
- a minimum of 2 years of claims processing and/or customer service experience
- WGS/CIW Claims Processing experience strongly desired
- Ability and comfortable working in a fast-paced production environment
- Ability to meet high quality standards is preferred
- Ability to read and follow specific instructions
- ITS Home and/or Host experience preferred
- AA/AS or higher-level degree preferred
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims processingauditingoverpayment recoverycontractual issue resolutionaccounts receivable managementcash applicationreportingdata analysisMedicare knowledgecustomer service
Soft skills
attention to detailcommunicationcollaborationproblem-solvingtime managementadaptabilitycustomer satisfaction focusinstruction followingquality assurancefast-paced work adaptability