Recovery Savings Analyst- Meritain

CVS Health; United States; À distance; USD 25 000 - 53 000; Plein temps

Avantages offerts par ce poste

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Résumé du poste

CVS Health is seeking an experienced Overpayment Recovery Specialist to recover and allocate overpaid dollars across complex refunds. You will coordinate with vendors and internal teams, research recovery inquiries, and conduct provider outreach to secure recoveries while maintaining compliance with company policies.

You will review and resolve excess payment items, manage recovery work inventory, and help drive timely resolution.

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 business units, vendors, and liaisons to recover funds and allocate refunds.
• Administer overpayment policies and procedures, including communications with members, providers, and insurers.
• Manage overpayment work inventory and follow up to achieve recovery goals.
• Coordinate with key business functions on escalated overpayments to drive resolution.
• Use analysis to solve complex, non-routine recovery issues.
• Use reporting to track inventory, productivity, and recovery results.
• Process complex provider refunds and returned checks.
• Review provider contract language to validate overpayments and support refund allocation.
• Deliver recovery training for less experienced team members.
• Handle customer service inquiries and issues.

Connaissances

Medical claims processing

Outbound calls

Customer service

Attention to detail

Guidelines interpretation

Formation

Associate degree or equivalent experience

Outils

DG system claims processing

Description du poste

Company Overview

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

Recover and allocate overpaid dollars, including complex, non-routine refunds. Manage overpayment inventory, partner with third-party vendors and internal business units, research and respond to recovery inquiries, and conduct provider outreach (including outbound calls) to secure recoveries. Ensure all work aligns with compliance requirements and company policies and procedures.

Key Responsibilities

Review, collect, and resolve overpayment recovery items, including conflicting, missing, or inaccurate information, via phone and written correspondence with limited supervision

Partner with internal business units, vendors, and liaisons to recover funds and fully allocate refunds

Administer overpayment recovery policies and procedures, including written and phone correspondence with members, providers, and other insurers

Manage overpayment work inventory; monitor progress and complete timely follow-ups to achieve recovery goals

Coordinate with key business functions on escalated overpayments to drive resolution and recovery

Use analysis and evaluation of alternatives to solve complex, non-routine recovery issues

Use reporting to track inventory, productivity, and recovery results

Perform claim adjustments and rework calculations across all dollar amounts using claims processing expertise

Apply medical necessity guidelines, determine coverage, verify eligibility, identify discrepancies, and apply cost containment measures to support claim adjudication

Process complex provider refunds and returned checks

Review and interpret provider contract language to validate overpayments and support allocation of refund checks

Deliver recovery training for less experienced team members as needed

Handle customer service inquiries and issues assigned

Required Qualifications

• 3+ years of medical claims processing experience
• 2+ year of medical claims adjustments and/or rework experience
• 2+ year of experience working 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

Preferred Qualifications

• Independent decision-making skills
• Effective communication, organizational, and interpersonal skills
• Familiarity with refund posting
• Familiarity with overpayment recovery DG system claims processing experience

Education

Associate degree or equivalent experience

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $18.50 - $38.82 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Benefits

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

Application Window

We anticipate the application window for this opening will close on: 11/24/2026

About the Company Culture

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.