Overpayment Recovery Specialist

CVS Health; Alton (IL); On-site; USD 25,000 - 53,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an Overpayment Recovery Specialist to support refunds and recovery efforts across complex cases. You will review, collect, and resolve overpayment recovery items by phone and written correspondence, ensuring alignment with compliance and company policies.

You will collaborate with internal teams and vendors to recover funds, allocate refunds, and manage recovery inventory to meet targets. Strong claims processing experience and meticulous attention to detail are essential.

Qualifications

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

Responsibilities

• Review and resolve overpayment recovery items via phone and written correspondence
• Partner with internal units and vendors to recover funds and allocate refunds
• Administer policies and procedures for overpayment recovery
• Monitor recovery inventory and follow up to meet goals
• Coordinate escalated overpayments with key functions
• Use analysis to solve complex recovery issues
• Produce reports tracking inventory, productivity, and results
• Process complex provider refunds and returned checks
• Review provider contracts to validate overpayments and refunds
• Deliver training to junior team members
• Handle customer service inquiries

Skills

Medical claims processing

Outbound calls

Customer service

Attention to detail

Eligibility interpretation

Education

Associate degree

Job description

CVS Health is seeking an Overpayment Recovery Specialist to support refunds and recovery efforts across complex cases. You will review, collect, and resolve overpayment recovery items by phone and written correspondence, ensuring alignment with compliance and company policies.

You will collaborate with internal teams and vendors to recover funds, allocate refunds, and manage recovery inventory to meet targets. Strong claims processing experience and meticulous attention to detail are essential.