Financial Operations Recovery Specialist II
| Company | Elevance Health |
|---|---|
| Location | Norfolk, VA, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | |
| Experience Level | Junior, Mid Level |
Requirements
- 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.
Responsibilities
- Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other 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 receivable processes and all other cash applications as required.
- Researches voluntary refunds for accuracy.
- Requires accurate balancing of all accounts.
Preferred Qualifications
- AA/AS or higher-level degree preferred.
- Experience processing claims with CI&W (WGS) preferred.
- Healthcare commercial claims operations experience preferred.
- JAA experience preferred.