Healthcare Overpayment Recovery Specialist

CVS Health; Oklahoma; Presencial; USD 25 000 - 53 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Resumo da oferta

CVS Health is seeking an Overpayment Recovery Specialist to recover and allocate overpaid dollars, including complex refunds. You will partner with providers, internal teams and vendors to secure recoveries while ensuring compliance with company policies.

This full-time role requires 3+ years of medical claims processing experience, strong attention to detail, and the ability to handle customer inquiries and outbound provider outreach in a fast-paced environment.

Qualificações

• 3+ years of medical claims processing experience.
• 2+ year of medical claims adjustments and/or rework experience.
• 2+ year of experience in a fast-paced, deadline-driven, high-volume environment.
• Experience conducting outbound calls, including provider outreach.
• Experience handling customer service inquiries via phone and/or written correspondence.

Responsabilidades

• Review, collect, and resolve overpayment recovery items via phone and written correspondence.
• Partner with internal units, vendors, and liaisons to recover funds and allocate refunds.
• Administer overpayment policies and procedures, including correspondence with members, providers, and other insurers.
• Manage overpayment work inventory; monitor progress and follow up to meet recovery goals.
• Coordinate escalated overpayments to drive resolution and recovery.
• Use analysis to solve complex, non-routine recovery issues.

Conhecimentos

Medical claims processing

Outbound calls

Customer service

Attention to detail

Data entry

Formação académica

Associate degree or equivalent experience

Ferramentas

DG system claims processing

Descrição da oferta de emprego

CVS Health is seeking an Overpayment Recovery Specialist to recover and allocate overpaid dollars, including complex refunds. You will partner with providers, internal teams and vendors to secure recoveries while ensuring compliance with company policies.

This full-time role requires 3+ years of medical claims processing experience, strong attention to detail, and the ability to handle customer inquiries and outbound provider outreach in a fast-paced environment.