Recovery Specialist Associate at Elevance Health Remote

Comunidade Metodista; United States; Remote; USD 42,000 - 52,000; Full time

Job summary

Elevance Health in Louisville, KY (hybrid role) seeks a Recovery Specialist Associate to identify, track, and reconcile provider overpayments and ensure recovery is reported under supervision.

You'll process daily provider refund checks and adjustments, interpret policy provisions, and respond to calls, emails, and letters from policyholders, agents, vendors and providers while maintaining HIPAA compliance and product knowledge.

Qualifications

• Requires a high school diploma or GED; 2+ years in claims or data entry.
• Equivalent combination of education and experience accepted.
• Healthcare claims processing experience preferred.

Responsibilities

• Process daily provider refund checks and adjustment requests from overpayment projects.
• Identify, track, and reconcile overpayments in accordance with policies.
• Respond to calls, letters, and emails from policyholders, agents, vendors and/or providers.
• Maintain working knowledge of Elevance Health products and services.
• Ensure HIPAA compliance in all duties.

Skills

Claims processing

Data entry

Customer service

HIPAA compliance

Education

High school diploma or GED

Job description

• Job Family: Finance and Actuarial
• Type: Full time
• Date Posted: Jan 02, 2024
• Anticipated End Date: Feb 19, 2024
• Reference: JR93170

Description

Recovery Specialist Associate

Location : Louisville, KY - Waukesha, WI - Indianapolis, IN

Hours: 9:30 am - 6 pm CST or 10:00 am - 7:00 pm EST

**This position is a hybrid position and will require you to work remotely and in the office**

A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The Recovery Specialist Associate is responsible for identifying, tracking, and reconciling overpayments made to providers and ensuring that recovery is made and reported under general supervision.

How you will make an impact:

• Performs all authorized duties in the processing of overpayments allocated to the assigned market consistent with all applicable company and departmental policies.
• Processes daily provider refund checks and adjustment requests from overpayment projects.
• Interprets policy provisions to accurately process overpayment adjustments in accordance with department policies.
• Responds to calls, letters, and emails from policyholders, agents, vendors and/or providers.
• Maintains working knowledge of all company products and services pertaining to business segment.
• Works with health plans regarding overpayment Provider disputes.
• Communicates with Providers regarding overpayment disputes on occasion.
• Adheres to company and department policies and procedures as well as HIPAA regulations.

Minimum Requirements:

• Requires H.S. diploma or GED preferred, a minimum 2 years of claims or data entry experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Medical claims processing experience preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [e-mail] assistance.