Overpayment Recovery Analyst – Medical Claims

CVS Health; Central City (CO); On-site; USD 25,000 - 53,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Job summary

CVS Health is seeking an experienced overpayment recovery specialist in Colorado. This role focuses on recovering and allocating overpaid dollars, handling complex refunds, and coordinating with internal teams and external vendors.

The position requires attention to compliance and policies while ensuring timely recoveries. The role supports outbound provider outreach and daily work in a fast-paced environment, with a typical 40-hour work week and opportunities for bonus eligibility beyond base

Qualifications

• 3+ years of medical claims processing experience.
• 2+ year of medical claims adjustments and/or rework experience.
• 2+ year in a fast-paced, deadline-driven, high-volume environment.
• Experience conducting outbound calls, including provider outreach.
• Experience handling customer service inquiries via phone or written correspondence.
• Ability to interpret and apply guidelines related to eligibility, coverage, and benefits.
• Demonstrated ability to manage multiple assignments with accuracy and attention to detail.

Responsibilities

• 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 recovery policies and procedures with members, providers, and insurers.
• Manage overpayment work inventory; monitor progress and follow up to achieve recovery goals.
• Coordinate with key business functions on escalated overpayments to drive resolution.
• Use analysis to solve complex, non-routine recovery issues.

Skills

Medical claims processing

Outbound calls

Customer service

Attention to detail

Time management

Education

Associate degree or equivalent experience

Tools

DG system claims processing

Job description

CVS Health is seeking an experienced overpayment recovery specialist in Colorado. This role focuses on recovering and allocating overpaid dollars, handling complex refunds, and coordinating with internal teams and external vendors.

The position requires attention to compliance and policies while ensuring timely recoveries. The role supports outbound provider outreach and daily work in a fast-paced environment, with a typical 40-hour work week and opportunities for bonus eligibility beyond base