Financial Operations Recovery Specialist III

🔥 1 minute ago

🐊 Florida, Ohio, +1 more states – Remote

🐊 Florida – Remote 🏈 Ohio – Remote ⚔️ Virginia – Remote

💵 $25 - $37 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💸 Financial Planning and Analysis (FP&A)

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Elevance Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Elevance Health is transforming from a traditional health benefits organization into a lifetime trusted health partner, driven by a bold purpose to improve the health of humanity. With nearly 100,000 associates, they serve over 118 million people and utilize an integrated whole health approach supported by industry-leading capabilities and a digital health platform. Their mission includes redefining health, reimagining the health system, and strengthening communities.

📋 Description

• Discover, validate, recover, and adjust claims overpayments • Audit paid claims for overpayments using systems-based queries, specialized reporting, and research • Interact regularly with staff and management from other departments to ensure customer satisfaction • Work with recovery and collection vendors to validate overpayments and vendor invoices • Provide feedback to modify vendor queries when needed • Collaborate with contract managers to identify and correct contractual issues • Handle complex case research and resolution • Perform collection activities to recover overpayments • Maintain unprocessed cash and accounts receivable processes and other cash applications • Review and monitor associate work for quality standards • Review department policy and procedure manuals for accuracy and completeness • Assist with special projects to find and prevent overpayments and identify process improvements • Complete special projects with minimal supervision • Research voluntary refunds for accuracy • Accurately balance all accounts

🎯 Requirements

• H.S. diploma or equivalent • Minimum of 4 years of claims processing and/or customer service experience • Any combination of education and experience providing an equivalent background • Proven experience in Claims Recovery • Knowledge of WGS • Knowledge of CIW • Knowledge of ITS • Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law • Associates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza

🏖️ Benefits

• Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution • Merit increases • Paid holidays • Paid Time Off • Incentive bonus programs • Medical benefits • Dental benefits • Vision benefits • Short-term disability benefits • Long-term disability benefits • 401(k) with match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources • Virtual work flexibility