Financial Operations Recovery Specialist III

Financial Operations Recovery Specialist III (US)

Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Financial Operations Recovery Specialist III (US) will be 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:

• Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other research.
• Interacts with staff and management from other departments on a regular basis to ensure customer satisfaction.
• May work with recovery and collection vendors to validate overpayments, validate vendor invoices and provide feedback to modify queries when needed.
• Works closely with contract managers to identify and correct contractual issues, if applicable.
• Handles complex case research and resolution.
• 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.
• May review and monitor associates work for quality standards.
• May review department policy and procedure manuals for accuracy and works to ensure procedures and policies are accurate and complete.
• Assists in special projects to find and prevent overpayments and to identify process improvements.
• Completes special projects as assigned with minimal supervision.
• Researches voluntary refunds for accuracy.
• Requires accurate balancing of all accounts.

Minimum Requirements: Requires a H.S. diploma or equivalent and a minimum of 4 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.
• Proven experience in Claims Recovery
• Knowledge in: WGS, CIW, ITS

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $25.00 to $37.50.

Location(s): Columbus, OH, and Virginia

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion, consistent with the law.

Job Level: Non-Management Non-Exempt

Workshift: 1st Shift (United States of America)

Job Family: AFA > Financial Operations