Financial Operations Recovery Specialist II
Core
Auditing paid claims for overpayments, validating cash receipts, and performing collections to recover funds for a health insurance company.
Role type
Financial Operations Recovery Specialist
Builds
Recovered cash and adjusted claims
Domain
Health Insurance / Claims Processing
Required skills
claims processing, customer service, systems-based queries, specialized reporting, coordination of benefits, Medicare policy knowledge, accounts receivable processes, collection activities, account balancing
Preferred skills
post-pay claim validation, high-volume claims environment experience, claims systems knowledge, medical coding, discrepancy identification
Technologies
claims systems, specialized reporting tools
Responsibilities
Audit paid claims for identified overpayments using systems-based queries and specialized reporting; Coordinate benefits and review Medicare and medical policies; Perform collection activities to ensure recovery of overpayments; Research voluntary refunds for accuracy; Balance all accounts accurately.
Seniority
Individual Contributor, 2+ years experience