Overpayment Recovery Specialist

First Roles; EE. UU.; Presencial; USD 25.000 - 53.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Descripción de la vacante

CVS Health is seeking a detail‑oriented Overpayment Recovery Specialist to review and resolve overpayment items, allocate refunds, and coordinate with internal teams and vendors. You will perform provider outreach and ensure compliance while managing inventory and meeting recovery goals.

The role requires extensive claims processing and adjustments experience, outbound communications with providers, and meticulous attention to accuracy in a fast-paced environment. Full-time, United States.

Formación

• 3+ years of medical claims processing experience.
• 2+ years of medical claims adjustments and/or rework experience.
• Experience in a fast-paced, deadline-driven environment.
• Outbound calls and provider outreach experience.
• Strong ability to interpret eligibility, coverage, and benefits guidelines.

Responsabilidades

• 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 policies and procedures with members, providers, and insurers.
• Manage recovery work inventory and conduct timely follow-ups to meet goals.
• Coordinate escalated overpayments with key business functions to drive resolution.
• Apply medical necessity guidelines to support claim adjudication.
• Process complex provider refunds and returned checks.

Conocimientos

Claims processing

Claims adjustments

Outbound calls

Customer service

Attention to detail

Educación

Associate degree

Herramientas

DG system

Descripción del empleo

CVS Health is seeking a detail‑oriented Overpayment Recovery Specialist to review and resolve overpayment items, allocate refunds, and coordinate with internal teams and vendors. You will perform provider outreach and ensure compliance while managing inventory and meeting recovery goals.

The role requires extensive claims processing and adjustments experience, outbound communications with providers, and meticulous attention to accuracy in a fast-paced environment. Full-time, United States.