Financial Operations Recovery Specialist I

Elevance Health • Richmond, GA

2d • Remote

About The Position

Be Part of an Extraordinary Team Carelon is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our strong, clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry. Build the Possibilities. Make an Extraordinary Impact. Title : Financial Operations Recovery Specialist I Location(s): Columbus, GA, Atlanta, GA, Mason, OH, Indianapolis, IN, Richmond, VA, Miami, FL Virtual: This role enables associates to work virtually full-time, with the exception of 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. 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 I is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Requirements

• Requires a H.S. diploma or equivalent and a minimum of 1 year of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Strong medical claims processing experience highly preferred.
• Proficient in Microsoft Excel
• AA/AS preferred.

Responsibilities

• Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.
• Determines and calculates amount of overpayments and processes refunds.
• Researches voluntary refunds for accuracy.
• Requires accurate balancing of all accounts.
• Responsible for more routine issues.
• May work with internal staff from other departments to ensure customer satisfaction.
• May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable balances and all other cash applications.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees