Financial Operations Recovery Specialist III

Job Description

Financial Operations Recovery Specialist III will be responsible for the discovery, validation, recovery, and adjustments of claims over payments and may support activities related to cash receipts, cash application, claim audits, collections, over payment vendor validation, and claim adjustments.

Location:

Norfolk, VA;
Nashville, TN;
Wilmington, DE;
Miami, FL; or Tampa, FL.

Virtual:
This role enables associates to work virtually full‑time, except for 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 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 accommodation is granted as required by law.

• Audit paid claims for over payments using various techniques including systems‑based queries, specialized reporting, or other research.
• Interact with staff and management from other departments on a regular basis to ensure customer satisfaction.
• Work with recovery and collection vendors to validate over payments, validate vendor invoices and provide feedback to modify queries when needed.
• Work closely with contract managers to identify and correct contractual issues, if applicable.
• Handle complex case research and resolution.
• Perform collection activities to ensure the recovery of over payments and maintenance of unprocessed cash and accounts receivable processes and all other cash applications as required.
• Review and monitor associates’ work for quality standards.
• Review department policy and procedure manuals for accuracy and work to ensure procedures and policies are accurate and complete.
• Assist in special projects to find and prevent over payments and to identify process improvements.
• Complete special projects as assigned with minimal supervision.
• Research voluntary refunds for accuracy.
• Require accurate balancing of all accounts.

Requires a H.S. diploma or equivalent and a minimum of 4 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.

• AA/AS or higher level degree preferred.
• Prior healthcare claims experience or knowledge strongly preferred.
• Experience working with FACETS preferred.
• Previous experience within the healthcare industry preferred.

For this specific position is $23.75 to $39.37. 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.

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• medical
• dental
• vision
• short‑term disability benefits
• long‑term disability benefits
• 401(k)+match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

Job Level: Non‑Management Non‑Exempt

Workshift: 1st Shift (United States of America)

Job Family: AFA >
Financial Operations

Job Title:

Financial Operations Recovery Specialist III

Anticipated End Date:

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…