Overpayment Recovery Specialist – Medical Claims

CVS Health; Alabama; 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

Other resources

Résumé du poste

CVS Health is seeking a detail-oriented professional to recover and allocate overpaid dollars, including complex refunds. You will engage with providers and internal teams, ensuring compliance and timely recoveries while maintaining high-quality service levels.

The role involves outbound outreach, policy administration, and analyzing recovery opportunities. A background in medical claims processing and strong communication are essential for success in a fast-paced environment at CVS Health.

Qualifications

• 3+ years of medical claims processing experience.
• 2+ years of medical claims adjustments/rework experience.
• 2+ years in fast-paced, deadline-driven, high-volume environment.
• Experience conducting outbound provider outreach calls.
• Experience handling customer service inquiries via phone or written correspondence.

Responsabilités

• Review and resolve overpayment recovery items via phone and written correspondence.
• Collaborate with internal units and vendors to recover funds and allocate refunds.
• Administer overpayment recovery policies and communications with members, providers, and insurers.
• Monitor overpayment work inventory and follow up to meet recovery goals.
• Coordinate escalated overpayments with key business functions for resolution.

Connaissances

Claims processing

Outbound calls

Customer service

Attention to detail

Communication

Formation

Associate degree or equivalent

Outils

DG system

Description du poste

CVS Health is seeking a detail-oriented professional to recover and allocate overpaid dollars, including complex refunds. You will engage with providers and internal teams, ensuring compliance and timely recoveries while maintaining high-quality service levels.

The role involves outbound outreach, policy administration, and analyzing recovery opportunities. A background in medical claims processing and strong communication are essential for success in a fast-paced environment at CVS Health.