Elevance Health Financial Operations Recovery Specialist II in W DES MOINES, Iowa
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Financial Operations Recovery Specialist II
Job Family: Finance and Actuarial
Type: Full time
Date Posted:Dec 04, 2023
Req #: JR94646
PA, SEVEN FIELDS
NY, NEW YORK
CT, ROCKY HILL
CA, RANCHO CORDOVA
LA, BATON ROUGE
NV, LAS VEGAS
MN, MENDOTA HEIGHTS
OH, SEVEN HILLS
FL, ALTAMONTE SPRINGS
NY, Lake Success
NY, Lake Success
CO, COLORADO SPRINGS
CA, WOODLAND HILLS
MO, JEFFERSON CITY
CA, WALNUT CREEK
TX, GRAND PRAIRIE
NY, EAST SYRACUSE
AR, LITTLE ROCK
CA, LOS ANGELES
MO, ST LOUIS
CA, COSTA MESA
NV, LAS VEGAS
CA, PALO ALTO
ME, SOUTH PORTLAND
IA, W DES MOINES
MA, NEWTON 55 CHAPEL ST
Financial Operations Recovery Specialist II
Location: Remote; must reside within 50 miles of an Elevance pulse point.
Hours: An 8 hour shift between the hours of 6:30 am - 5:30 pm.
* Training is from 8 am - 5 pm EST *
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.
How you will make an impact:
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.
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.
- Requires a H.S. diploma 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:
AA/AS or higher level degree preferred.
Medical claims processing experience preferred.
Proficient in Microsoft Excel
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $20.77 to $ 37.38
Locations : California; Colorado; Nevada; New York; Washington State; Jersey City, NJ
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 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 for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
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.
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.
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. 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.
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@example.com for assistance.
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