Overpayment Recovery Specialist

CVS Health; Tallahassee (FL); Sur place; USD 25 000 - 53 000; Plein temps

Avantages offerts par ce poste

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health in Florida is seeking an experienced Overpayment Recovery Specialist to review and recover overpaid dollars, including complex refunds. This full-time role involves outbound provider outreach, working with internal teams and external vendors, and ensuring adherence to compliance and policy.

Responsibilities include processing recoveries, managing refunds, handling inquiries by phone and written correspondence, and providing training to junior teammates.

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.
• Experience conducting outbound calls, including provider outreach.
• Experience handling customer service inquiries via phone and/or written correspondence.
• Ability to interpret and apply guidelines related to eligibility, coverage, and benefits.
• Demonstrated ability to manage multiple assignments with a high degree of accuracy and attention to detail.

Responsabilités

• 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 with members, providers, and other insurers.
• Manage overpayment inventory; monitor progress and perform timely follow-ups.
• Coordinate with key business functions on escalated overpayments to drive resolution.
• Use analysis to solve complex, non-routine recovery issues and track results.

Connaissances

Medical claims processing

Claims adjustments/Rework

Outbound calls

Customer service inquiries

Eligibility/coverage/benefits guidance

Attention to detail

Multi-tasking

Formation

Associate degree or equivalent experience

Description du poste

CVS Health in Florida is seeking an experienced Overpayment Recovery Specialist to review and recover overpaid dollars, including complex refunds. This full-time role involves outbound provider outreach, working with internal teams and external vendors, and ensuring adherence to compliance and policy.

Responsibilities include processing recoveries, managing refunds, handling inquiries by phone and written correspondence, and providing training to junior teammates.