Financial Operations Recovery Specialist II

Elevance Health • Norfolk, VA

1d • Remote

About The Position

Financial Operations Recovery Specialist II Location: Norfolk, VA 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. 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. Carelon Health is a proud member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. 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

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.

Nice To Haves

• AA/AS or higher level degree preferred.
• FACETS, Macess, and CCERT experienced preferred.

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.

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: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees