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Anthem, Inc. Financial Operations Recovery Specialist III in Richmond, Virginia

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve.

Financial Operations Recovery Specialist III

Work Location: Remote

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

  • Requires a H.S. diploma; 4-5 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.

  • Associate degree or higher level degree preferred.

  • Proficient in MS Office.

  • Excellent written and verbal communication.

    Applicable to Colorado Applicants Only Hourly Pay Range*: $21.46 - $26.83/hr Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. * The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. 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. An Equal Opportunity Employer/Disability/Veteran.

    Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

    REQNUMBER: PS44002

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