Financial Operation Recovery Specialist II

About the role

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

How You Will Make An Impact

• Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or another 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 for receivable processes and all other cash applications as required
• Research voluntary refunds for accuracy
• Requires accurate balancing of all accounts

Minimum Qualifications

• Requires a H.S. diploma or equivalent 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

Preferred Skills, Capabilities And Experiences

• AA/AS degree or higher preferred
• Experience in claims adjustment and/or customer service
• Experience with the following systems: CIW WGS

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical, dental, vision, short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources