Financial Operations Recovery Specialist III

Anticipated End Date: 2026-09-09 Position Title: Financial Operations Recovery Specialist III Job Description: Virtual:   This role enables associates to work   virtually full-time , except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates   reside   within a commuting distance from an office.     Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.  The Financial Operations Recovery Specialist III (US) will be responsible for the discovery, validation, recovery, and adjustments of claims overpayments and may support activities related to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.     How you will make an impact: 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.

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 Skills, Capabilities and Experiences:  AA/AS degree or higher preferred  Experience in claims adjustment and/or customer service  Experience with the following systems:  CIW  WGS  Job Level: Non-Management Non-Exempt Workshift: 1st Shift (United States of America) Job Family: AFA > Financial Operations Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and