Strategic Overpayment Recovery Analyst

CVS Health; Little Elm (TX); On-site; USD 32,000 - 54,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

CVS Health is seeking a detail-oriented team member to recover and allocate overpaid dollars, including complex refunds. You will work with internal teams and external vendors to recover funds while ensuring compliance and policy alignment.

Responsibilities include handling outbound provider outreach, conducting reviews of overpayments, and performing claim adjustments with accuracy in a fast-paced environment. This full-time role offers comprehensive benefits.

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.

Responsibilities

• 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 recovery policies and procedures with members, providers, and other insurers.
• Manage overpayment work inventory; monitor progress and perform timely follow-ups.
• Deliver recovery training for less experienced team members as needed.

Skills

Medical claims processing

Claims adjustments

Outbound calls

Customer service

Eligibility interpretation

Education

Associate degree or equivalent experience

Tools

DG system

Job description

CVS Health is seeking a detail-oriented team member to recover and allocate overpaid dollars, including complex refunds. You will work with internal teams and external vendors to recover funds while ensuring compliance and policy alignment.

Responsibilities include handling outbound provider outreach, conducting reviews of overpayments, and performing claim adjustments with accuracy in a fast-paced environment. This full-time role offers comprehensive benefits.