Financial Operations Recovery Specialist III

Elevance Health; Wilmington (DE); Hybrid; USD 33,000 - 54,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

401k match

Stock purchase plan

Life insurance

Medical coverage

Dental coverage

Vision coverage

Wellness programs

Job summary

Elevance Health is seeking a Financial Operations Recovery Specialist III to lead the discovery, validation, recovery, and adjustments of claims overpayments. The role may support related cash applications, audits, and vendor validation in a hybrid, partially remote setting.

The position requires a HS diploma and 4+ years in claims processing or customer service, with preferred healthcare claims knowledge and FACETS experience.

Qualifications

• Requires a high school diploma or equivalent.
• Minimum of 4 years of claims processing and/or customer service experience.

Responsibilities

• Audit paid claims for overpayments using various techniques.
• Interact with staff and management from other departments to ensure customer satisfaction.
• Work with recovery and collection vendors to validate overpayments and provide feedback to modify queries.

Skills

Claims processing

Customer service

Attention to detail

Education

High School Diploma

Tools

FACETS

Job description

Job Description

Financial Operations Recovery Specialist III will be responsible for the discovery, validation, recovery, and adjustments of claims overpayments and may support activities related to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Location & Work Arrangement

Location: Norfolk, VA; Nashville, TN; Wilmington, DE; Miami, FL; or Tampa, FL.

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 accommodation is granted as required by law.

Key Responsibilities

• Audit paid claims for overpayments using various techniques including systems‑based queries, specialized reporting, or other research.
• Interact with staff and management from other departments on a regular basis to ensure customer satisfaction.
• Work with recovery and collection vendors to validate overpayments, validate vendor invoices and provide feedback to modify queries when needed.
• Work closely with contract managers to identify and correct contractual issues, if applicable.
• Handle complex case research and resolution.
• 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.
• Review and monitor associates’ work for quality standards.
• Review department policy and procedure manuals for accuracy and work to ensure procedures and policies are accurate and complete.
• Assist in special projects to find and prevent overpayments and to identify process improvements.
• Complete special projects as assigned with minimal supervision.
• Research voluntary refunds for accuracy.
• Require 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.
• Prior healthcare claims experience or knowledge strongly preferred.
• Experience working with FACETS preferred.
• Previous experience within the healthcare industry preferred.

Salary

For this specific position is $23.75 to $39.37. 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.

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• medical
• dental
• vision
• short‑term disability benefits
• long‑term disability benefits
• 401(k)+match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

Job Details

Job Level: Non‑Management Non‑Exempt

Workshift: 1st Shift (United States of America)

Job Family: AFA > Financial Operations

Job Title: Financial Operations Recovery Specialist III

Anticipated End Date: 2026-09-30

Company Overview

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.

Hybrid Workforce Strategy

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.

Health & Safety

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.

Equal Employment Opportunity

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.

Accessibility

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

Criminal Background

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.

Florida Disclosure

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

Additional Information

Please visit the Contract Worker Community Page.

Contact

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.