Financial Operations Recovery Specialist

Overview

Location:

Virtual. This role enables the associate to work virtually full-time, with the exception of required in-person training sessions, providing flexibility and autonomy. Please note that per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered unless an accommodation is granted as required by law.

Financial Operations Recovery Specialist I is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures.

• Participate in claims workflow projects.
• Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims.
• Adjusts voids and reopens claims online within guidelines to ensure proper adjudication.
• May have customer/client contact.
• May assist with training of staff.
• Works without significant guidance.

• Requires a HS diploma and a minimum of 3 years of the company’s internal claims experience; or any combination of education and experience which would provide an equivalent background.

• Government claim processing experience STRONGLY preferred.
• TS Home and/or Host experience preferred.
• Claim Adjustment experience preferred.
• Demonstrated ability to work independently, prioritize workload, and take ownership of daily deliverables with minimal supervision.
• Strong ability to read, interpret, and accurately apply documented policies, procedures, and processing steps to ensure compliant, consistent outcomes.
• Flexibility to shift between work types (e.g., queues, outreach, research, corrections) and adapt quickly to changing priorities while maintaining production and quality standards.
• 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.

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.

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 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 and support personal and professional growth for our associates. Our values and behaviors are the root of our culture and guide our approach to achieving our strategy and delivering outcomes for consumers, associates, communities, and the business. We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long-term disability benefits, 401(k) with match, stock purchase plan, life insurance, wellness programs, and financial education resources.

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 onsite requirements will be discussed during the hiring process. The health of our associates and communities is a top priority. We require all new candidates in certain patient/member-facing roles to be vaccinated against COVID-19 and Influenza.

If you are not vaccinated, your offer may be rescinded unless you provide an acceptable explanation. Elevance Health will follow all relevant federal, state, and local laws.

Elevance…