Anthem Inc. Virginia Jobs

Job Information

Anthem, Inc. Financial Operations Recovery Specialist I, II, III in Harrisonburg, Virginia

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team 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?

The Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously identified. 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:

  • Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.

  • Determines and calculates amount of overpayments and processes refunds.

  • Researches voluntary refunds for accuracy.

  • Requires accurate balancing of all accounts.

  • Responsible for more routine issues.

  • May work with internal staff from other departments to ensure customer satisfaction.

  • May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable balances and all other cash applications.

The Finance 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

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.

The 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

Financial Operations Recovery Specialist I primary requirements:

  • Requires a H.S. diploma

  • Minimum of 1 year of claims processing and/or customer service experience

  • Any combination of education and experience, which would provide an equivalent background.

Financial Operations Recovery Specialist I preferred requirements:

  • AA/AS preferred.

Financial Operations Recovery Specialist II primary requirements:

  • Requires a H.S. diploma

  • Minimum of 2 years of claims processing and/or customer service experience

  • Any combination of education and experience, which would provide an equivalent background.

Financial Operations Recovery Specialist II preferred requirements:

  • AA/AS or higher level degree preferred.

Financial Operations Recovery Specialist III primary requirements:

  • Requires a H.S. diploma

  • Minimum of 4 years of claims processing and/or customer service experience

  • Any combination of education and experience, which would provide an equivalent background.

Financial Operations Recovery Specialist III preferred requirements:

  • AA/AS or higher level degree preferred.

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 Anthem. 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 Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. 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.antheminc.com. Anthem 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 ability@icareerhelp.com for assistance.

REQNUMBER: PS72787

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