The Financial Operations Recovery Specialist II is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to cash receipts, cash application, claim audits collections, overpayment vendor validation, and claim adjustments.
Location: The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
How you will make an impact:
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.
Minimum Requirements:
Requires a H.S. diploma and a minimum of 2 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.
