Elevance Health · 7 hours ago
Financial Operations Recovery Spec III
Richmond, VA
Full-time
Hybrid
Mid Level
4+ years expElevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. The Financial Operations Recovery Specialist III is responsible for the discovery, validation, recovery, and adjustments of claims overpayments, ensuring effective cash management and compliance with company policies.
Health CareHealth InsurancePersonal HealthWellness
Responsibilities
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
Responsible for validating Provider/Member Outstanding checks, and Escheat Checks
Responsible for requesting overpayment (Interest/Prompt Pay)
May work with recovery and collection vendors to validate overpayment, 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
Assist Lead with weekly reports and training
Qualification
Required
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
Preferred
AA/AS or higher level degree preferred
4 plus years of all Claims processing experience of these systems (WGS, Facets, CHIPS, CS90, Nasco, BlueSquare)
Proficiency in Anthem Claims Recovery (ACR); Claims Overpayment Recovery (COR); WellPoint Content Frameworkk (WCF); Business Distributor System (BDS); and Check inquiry
Benefits
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical
Dental
Vision
Short and long term disability benefits
401(k) +match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Company
Elevance Health
Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.
10001+ employees
H1B Sponsorship
Elevance Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (488)
2024 (604)
2023 (660)
2022 (222)
Funding
Current Stage
Public CompanyTotal Funding
unknown2001-10-30IPO
Leadership Team
Gail K. Boudreaux
President and CEO
Geeta Wilson
Chief Technology Officer (CTO): Digital Health and Service Experience Platforms
Recent News
2026-01-25
Company data provided by crunchbase