Financial Operations Recovery Specialist I/II/III

Elevance Health, Inc.; Virginia; Ibrido; USD 32.000 - 48.000; Tempo pieno

Vantaggi offerti da questo lavoro

Comprehensive benefits package

Incentive programs

Equity stock purchase

401(k) contribution

Descrizione del lavoro

Elevance Health is seeking a Financial Operations Recovery Specialist I/II/III to lead discovery, validation, recovery, and adjustments of claim overpayments. This role may involve cash receipts, cash application, claim audits, collections, and vendor validation.

This position supports hybrid/virtual work; location Virginia, with a salary range of $23.08 - $34.62 per hour. Requires a high school diploma and at least 4 years in claims processing or customer service; experience with Facets, CIW,

Competenze

• Requires a High School diploma or equivalent and a minimum of 4 years of claims processing and/or customer service experience.
• AA/AS or higher level degree preferred.
• Experience with listed systems (Facets, CIW, CCert, ACR, Work IQ, BlueSquared, WGS) preferred.

Mansioni

• Audit paid claims for overpayments using queries, reporting, or research.
• Interact with staff from other departments to ensure customer satisfaction.
• Collaborate with recovery and collection vendors to validate overpayments and vendor invoices.
• Work with contract managers to identify and fix contractual issues.
• Handle complex case research and resolution.
• May perform collection activities to recover overpayments and manage cash applications.
• Review department policies for accuracy and completeness.
• Assist in special projects to prevent overpayments and identify process improvements.
• Complete special projects with minimal supervision.
• Research voluntary refunds for accuracy.
• Balance all accounts accurately.

Conoscenze

Attention to detail

Analytical thinking

Communication

Formazione

High School diploma or equivalent

AA/AS or higher

Strumenti

Facets

CIW

CCert

ACR

Work IQ

BlueSquared

WGS

Descrizione del lavoro

Financial Operations Recovery Specialist I/II/III

Location: Near any Elevance Health Pulse Point location.

Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Financial Operations Recovery Specialist I/II/III is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

How you will make an impact

• Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other research.
• Interacts with staff and management from other departments on a regular basis to ensure customer satisfaction.
• May work with recovery and collection vendors to validate overpayments, validate vendor invoices and provide feedback to modify queries when needed.
• Works closely with contract managers to identify and correct contractual issues, if applicable.
• Handles complex case research and resolution.
• 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.
• May review and monitor associates work for quality standards.
• May review department policy and procedure manuals for accuracy and works to ensure procedures and polices are accurate and complete.
• Assists in special projects to find and prevent overpayments and to identify process improvements.
• Completes special projects as assigned with minimal supervision.
• Researches voluntary refunds for accuracy.
• Requires accurate balancing of all accounts.

Minimum Requirements

• Requires a H.S. diploma or equivalent and a minimum of 4 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences

• AA/AS or higher level degree preferred.
• Experience with systems such as Facets, CIW, CCert, ACR, Work IQ, BlueSquared, and WGS preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $23.08 - $34.62.

Location: Virginia

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.