Overpayment Recovery Specialist

CVS Health; Muncie (IN); On-site; USD 25,000 - 53,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Retirement savings options

Paid time off

Job summary

CVS Health is seeking a full-time Overpayment Recovery Specialist in Indiana to recover and allocate refunds, research inquiries, and perform provider outreach. You will ensure compliance and accuracy while coordinating with internal teams and vendors.

The role requires 3+ years of medical claims processing experience and a focus on timely, compliant recoveries in a fast-paced environment. 40 hours/week, with benefits and bonus eligibility.

Qualifications

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

Responsibilities

• Review, collect, and resolve overpayment recovery items via phone and written correspondence.
• Partner with internal units and vendors to recover funds and allocate refunds.
• Administer overpayment recovery policies and procedures with members and providers.
• Monitor inventory and perform timely follow-ups to meet recovery goals.
• Coordinate with key functions on escalated overpayments for resolution.
• Use analysis to solve complex, non-routine recovery issues.
• Use reporting to track inventory, productivity, and recovery results.
• Perform claim adjustments and rework calculations across dollar amounts.

Skills

Medical claims processing

Claims adjustments

High-volume environment

Outbound calls

Customer service

Guidelines interpretation

Multi-tasking

Education

Associate degree

Job description

CVS Health is seeking a full-time Overpayment Recovery Specialist in Indiana to recover and allocate refunds, research inquiries, and perform provider outreach. You will ensure compliance and accuracy while coordinating with internal teams and vendors.

The role requires 3+ years of medical claims processing experience and a focus on timely, compliant recoveries in a fast-paced environment. 40 hours/week, with benefits and bonus eligibility.