Overpayment Recovery Specialist

CVS Health; Saint Paul (MN); On-site; USD 25,000 - 53,000; Full time

Job summary

CVS Health is seeking an Overpayment Recovery Specialist to recover and allocate overpaid dollars, including complex refunds, and to manage an overpayment inventory. You will partner with internal teams and third-party vendors, research and respond to inquiries, and conduct provider outreach to secure recoveries.

The role emphasizes compliance, accuracy, and timely follow-ups to meet recovery goals, with outbound calls and written communications as needed.

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, high-volume environment.

Responsibilities

• Review, collect, and resolve overpayment recovery items via phone and written correspondence with limited supervision.
• Partner with internal units and vendors to recover funds and allocate refunds.
• Administer overpayment policies and procedures with members, providers, and other insurers.

Skills

Medical claims processing

Claims adjustments

Outbound calls

Customer service

Attention to detail

Guideline interpretation

Education

Associate degree or equivalent experience

Job description

CVS Health is seeking an Overpayment Recovery Specialist to recover and allocate overpaid dollars, including complex refunds, and to manage an overpayment inventory. You will partner with internal teams and third-party vendors, research and respond to inquiries, and conduct provider outreach to secure recoveries.

The role emphasizes compliance, accuracy, and timely follow-ups to meet recovery goals, with outbound calls and written communications as needed.