Financial Ops Recovery Specialist II

Anticipated End Date: 2026-08-15 Position Title: Financial Ops Recovery Specialist II Job Description: Financial Ops Recovery Specialist II LOCATION This is a virtual eligible role. You must be within a reasonable distance of one of our eligible offices. HOURS General business hours, Monday through Friday. Hybrid 1 This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. 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. Responsibilities 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 or equivalent 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 Medical claims processing/adjustment experience preferred. Experience in Facets preferred. Experience in Macess preferred. A.A./A.S. preferred. Strong ability to read, interpret, and accurately apply documented policies, procedures, and processing steps to ensure compliant, consistent outcomes. High attention to detail and accuracy when reviewing financial information, resolving discrepancies, and documenting actions in required systems. Effective time management and organization skills to meet deadlines and service-level expectations in a high-volume environment. Location(s) Nevada Salary For candidates working in person or virtually in the below locations, the salary* range for this specific position is $24.23 - $36.35/hr. Benefits Comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). 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. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs, 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. Workweek and Shift Full-time, 1st Shift (United States of America) Job Family AFA > Financial Operations Job Level Non-Management 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. Hybrid Workforce Strategy 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. Vaccination Requirements We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. 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. Equal Opportunity Employer 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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration. 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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Elevance Health is an Equal Opportunity Employer/Disability/Veterans. Contractor Community Please visit the Contract Worker Community Page. #J-18808-Ljbffr The Elevance Health Companies, Inc.