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 may include cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Responsibilities

• Audits paid claims for overpayments using systems-based queries, specialized reporting, or other research.
• Handles complex issues such as coordination of benefits, Medicare, and medical policies.
• Collaborates regularly with staff from other departments to ensure customer satisfaction.
• Works with contract managers to identify and correct contractual issues when applicable.
• Performs collection activities to recover overpayments and maintains unprocessed cash, accounts receivable, and cash application processes.
• Researches voluntary refunds for accuracy and balances 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 organizational skills to meet deadlines in a high-volume environment.

Pay

For candidates working in Virginia, the hourly salary range for this position is $23.08 – $34.62. The range may vary based on geographic location, work experience, education, and skill level.

Benefits

• Comprehensive benefits package (medical, dental, vision, short- and long-term disability).
• 401(k) with company match and stock purchase plan.
• Paid holidays, paid time off (PTO), and incentive bonus programs.
• Life insurance, wellness programs, and financial education resources.