Financial Operations Recovery Specialist III
Core
Auditing paid claims for overpayments, validating vendor invoices, and managing cash application and collections processes.
Role type
Senior IC financial operations specialist (claims recovery)
Builds
Accurate claim adjustments and recovered overpayments for healthcare payers
Domain
Healthcare / Insurance / Financial Operations
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
claims processing, customer service, account balancing, case research, vendor validation, collection activities, policy review, process improvement
Preferred skills
healthcare claims experience, FACETS system proficiency, healthcare industry background
Responsibilities
Audit paid claims for overpayments using systems-based queries and specialized reporting; interact with staff and management to ensure customer satisfaction; work with recovery and collection vendors to validate overpayments and invoices; handle complex case research and resolution; perform collection activities to recover overpayments; review and monitor associate work for quality standards; assist in special projects to prevent overpayments and identify process improvements
Seniority
Mid-Senior level, individual contributor
