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Financial Operations Recovery Specialist IIIJob Family: Finance and Actuarial
Type: Full time
Date Posted:Sep 27, 2022
Req #: JR26695
Location:National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
DescriptionDescription - ExternalThe Financial Operations Recovery Specialist III 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.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.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 polices 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.Qualifications - ExternalPrimary qualificationsRequires a H.S. diplomaMinimum of 4 years of claims processing and/or customer service experienceAny combination of education and experience, which would provide an equivalent background.Preferred qualificationsAA/AS or higher level degree preferred.Applicable to Colorado Applicants OnlyHourly Pay Range: $21.12/hr - $26.40/hr (Min – MRP)Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. The hourly or 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. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be 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 Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.Be part of an Extraordinary TeamElevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?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.The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. 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 may contact [email protected] for assistance.EEO is the LawEqual Opportunity Employer / Disability / VeteranPlease use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.EEO Policy Statement
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Elevance Health, Inc. is an E-verify EmployerNeed Assistance?Email us ([email protected]) or call 1-877-204-7664
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