Financial Operations Recovery Specialist Ii

at Elevance Health in MERIDIAN, Idaho, United States

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Financial Operations Recovery Specialist II

+ Job Family: Finance and Actuarial

+ Type: Full time

+ Date Posted:Dec 07, 2023

+ Req #: JR94646

Location:

+ VA, NORFOLK

+ PA, SEVEN FIELDS

+ VA, ARLINGTON

+ FL, MIAMI

+ MA, BOSTON

+ IN, INDIANAPOLIS

+ OH, CINCINNATI

+ NY, NEW YORK

+ CT, ROCKY HILL

+ CA, RANCHO CORDOVA

+ LA, BATON ROUGE

+ MI, WIXOM

+ TN, BRENTWOOD

+ DC, WASHINGTON

+ MD, ANNAPOLIS

+ NV, LAS VEGAS

+ MN, MENDOTA HEIGHTS

+ TN, KNOXVILLE

+ MO, SPRINGFIELD

+ MO, COLUMBIA

+ VA, ASHBURN

+ OH, COLUMBUS

+ NC, CARY

+ WA, LAKEWOOD

+ WI, MADISON

+ WV, CHARLESTON

+ NE, LINCOLN

+ DE, WILMINGTON

+ NE, OMAHA

+ OH, SEVEN HILLS

+ ID, MERIDIAN

+ ID, MERIDIAN

+ RI, SMITHFIELD

+ MA, HINGHAM

+ NC, WINSTON

+ GA, ATLANTA

+ DC, WASHINGTON

+ IL, DEERFIELD

+ VA, RICHMOND

+ KY, SHELBYVILLE

+ FL, ALTAMONTE SPRINGS

+ MI, DEARBORN

+ NY, Lake Success

+ FL, TALLAHASSEE

+ KS, TOPEKA

+ VA, ROANOKE

+ NY, Lake Success

+ CO, COLORADO SPRINGS

+ FL, JACKSONVILLE

+ CA, WOODLAND HILLS

+ MD, BALTIMORE

+ NJ, LAKEWOOD

+ WI, Waukesha

+ NJ, MORRISTOWN

+ TN, MEMPHIS

+ MO, JEFFERSON CITY

+ NY, ALBANY

+ OH, MASON

+ CA, SACRAMENTO

+ CA, WALNUT CREEK

+ KY, LOUISVILLE

+ PA, HERMITAGE

+ WA, SEATTLE

+ NH, MANCHESTER

+ TX, GRAND PRAIRIE

+ IL, CHICAGO

+ NY, EAST SYRACUSE

+ TX, AUSTIN

+ MI, DEARBORN

+ TX, DENISON

+ VA, CHESAPEAKE

+ CA, GLENDALE

+ TN, NASHVILLE

+ MN, GILBERT

+ LA, METAIRIE

+ NY, MIDDLETOWN

+ AR, LITTLE ROCK

+ IL, SPRINGFIELD

+ GA, MIDLAND

+ TX, HOUSTON

+ CA, LOS ANGELES

+ CT, WALLINGFORD

+ MO, ST LOUIS

+ CA, COSTA MESA

+ MD, HANOVER

+ NJ, ISELIN

+ CA, CERRITOS

+ OH, MASON

+ IL, CHICAGO

+ CO, DENVER

+ NV, LAS VEGAS

+ PA, HARRISBURG

+ CA, PALO ALTO

+ ME, SOUTH PORTLAND

+ NY, LATHAM

+ OH, COLUMBUS

+ GA, AUGUSTA

+ IA, W DES MOINES

+ MA, WOBURN

+ MA, NEWTON 55 CHAPEL ST

Description

Financial Operations Recovery Specialist II

Location: Remote; must reside within 50 miles of an Elevance pulse point.

Hours: An 8 hour shift between the hours of 6:30 am - 5:30 pm.

• Training is from 8 am - 5 pm EST **

The Financial Operations Recovery Specialist II is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to cash receipts, cash application, claim audits collections, overpayment vendor validation, and claim adjustments.

How you will make an impact:

+ Primary duties may include, but are not limited to: Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other research.

+ Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies.

+ Works closely with staff from other departments on a regular basis to ensure customer satisfaction.

+ Works closely with contract managers to identify and correct contractual issues when applicable.

+ May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable processes and all other cash applications as required.

+ Researches voluntary refunds for accuracy.

+ Requires accurate balancing of all accounts.

Minimum Requirements:

+ Requires a H.S. diploma and a minimum of 2 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

+ AA/AS or higher level degree preferred.

+ Medical claims processin