CSR ( Financial Ops Recovery Spec I )

Carelon Global Solutions Philippines Inc; Taguig; On-site; PHP 240,000 - 360,000; Full time

Job summary

Carelon Global Solutions Philippines Inc is seeking a CSR (Financial Ops Recovery Spec I) to set up and adjust claims overpayments and support cash receipts, cash application, and claim adjustments.

The role involves reviewing paid claims for overpayments, calculating refund amounts, researching voluntary refunds, and balancing accounts. The position suits recent graduates with HS diploma and 1-2 years in claims processing or customer service.

Qualifications

• Requires a high school diploma.
• 1-2 years of claims processing and/or customer service experience.
• Associate degree preferred.

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.
• Requires accurate balancing of all accounts.
• Responsible for 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 and accounts receivable balances and all other cash applications.

Education

High School Diploma

Associate degree preferred

Job description

Position Title: CSR ( Financial Ops Recovery Spec I )

Shift: Job Description: Responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments. Primary duties may include, but are not limited to:

• 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.
• Requires accurate balancing of all accounts.
• Responsible for 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 and accounts receivable balances and all other cash applications.

Requires a H.S. diploma; 1-2 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background. Associate degree preferred.

Care meets innovation

Our name translates to “providing full and complete care” and reinforces our commitment to putting people first in all that we do. We specialize in contact center operations (call and chat) and clinical nurse operations for Elevance Health. With four offices in prime locations across the Philippines—two in Manila and two in Iloilo—we boast a talent pool of more than 9,000 associates all working together to improve healthcare operations. We use the right balance of care, technology, data, and expertise to streamline experiences and create value for our clients, people, and community. We also recognize the value that our associates bring, and that is why we are committed to providing the same through competitive compensation and comprehensive benefits such as rewards and recognition programs, health and medical insurance, and best-in-class amenities to keep associates and their families healthy and secure.

At Carelon Global Solutions Philippines, we care for those who provide care. Join us today.

We celebrate and leverage our associates' limitless skills, talents, unique perspectives, and experiences. By respecting our people's culture and background, we foster a collaborative and purpose-driven workplace where everyone can grow and thrive in their careers.

If you are a recent senior high school or college graduate looking to get a head start in your career, we are the right team for you.