Financial Ops Recovery Specialist II

This is a virtual-eligible role. You must be within a reasonable commuting distance of one of our eligible offices. Hybrid schedule: 1–2 days per week in-office.

About the role

The Financial Operations Recovery Specialist II discovers, validates, recovers, and adjusts claims overpayments. Responsibilities span cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Responsibilities

• Audit paid claims for overpayments using systems-based queries, specialized reporting, or other research.
• Handle complex issues such as coordination of benefits, Medicare, and medical policies.
• Collaborate regularly with staff from other departments to ensure customer satisfaction.
• Work with contract managers to identify and correct contractual issues.
• Perform collection activities to recover overpayments and maintain unprocessed cash, accounts receivable, and cash-application processes.
• Research voluntary refunds for accuracy and balance all accounts.

Requirements

• High school diploma or equivalent.
• Minimum of 2 years of claims processing and/or customer service experience, or equivalent combination of education and experience.

Preferred Qualifications

• Medical claims processing/adjustment experience.
• Experience with Facets or Macess systems.
• Associate degree (A.A./A.S.).
• Strong ability to read, interpret, and apply documented policies and procedures.
• High attention to detail and accuracy in reviewing financial information and resolving discrepancies.
• Effective time management and organization skills to meet deadlines in a high-volume environment.

Pay

For candidates working in Nevada, the salary range for this position is $24.23 – $36.35 per hour.

Benefits

• Comprehensive benefits package (medical, dental, vision, short- and long-term disability).
• 401(k) with company match and equity stock purchase plan.
• Incentive and recognition programs.
• Paid holidays, Paid Time Off (PTO), and wellness programs.
• Financial education resources.