Financial Operations Recovery Specialist I

Work location: Virtual. This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. Candidates must be within a reasonable commuting distance from an Elevance Pulse Point office unless an accommodation is granted as required by law.

About the role

The Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously identified. Responsibilities may include cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Responsibilities

• Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.
• Determines and calculates amount of overpayments and processes refunds.
• Researches voluntary refunds for accuracy, requiring accurate balancing of all accounts.
• Handles more routine issues.
• May work with internal staff from other departments to ensure customer satisfaction.
• May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash, accounts receivable balances, and all other cash applications.

Requirements

• High school diploma or equivalent.
• Minimum of 1 year of claims processing and/or customer service experience; or any combination of education and experience that provides an equivalent background.

Preferred Qualifications

• Associate degree (AA/AS) preferred.
• Previous claims experience and/or experience within the healthcare/health insurance industry.

Pay

For candidates working in person or virtually in Virginia or Massachusetts, the salary range for this position is $19.54/hour to $35.50/hour. The salary offered is based on legitimate, non-discriminatory factors set by the company.

Benefits

• Comprehensive benefits package (medical, dental, vision, short and long-term disability).
• 401(k) contribution with company match.
• Equity stock purchase plan.
• Incentive and recognition programs.
• Paid holidays and Paid Time Off (PTO).
• Life insurance.
• Wellness programs and financial education resources.

Schedule

This role follows a Hybrid Workforce Strategy, requiring associates to work at an Elevance Health location at least once per week, with specific expectations discussed during the hiring process.

About Us

Elevance Health is a Fortune 25 health company dedicated to improving lives and communities while simplifying healthcare. We seek leaders passionate about making an impact on our members and communities.

Our culture is rooted in values and behaviors that drive our strategy, business outcomes, and shared success for consumers, associates, and communities.