Anthem Financial Operations Recovery Specialist II - Nationwide (Office Based or Remote) - PS13138 in Reno, Nevada

Financial Operations Recovery Specialist II - Nationwide (Office Based or Remote) - PS13138

Location: United States

Field: Accounting/Finance/Auditing

Requisition #: PS13138

Post Date: Oct 09, 2018

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 II

This is an office-based or remote, work-from-home position. You must live within 1 hour of any Anthem office to be considered.

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.

  • Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies.

  • Works closely with staff from other departments on a regular basis to ensure customer satisfaction.

  • Works closely with contract managers to identify and correct contractual issues when applicable.

  • 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.

  • Researches voluntary refunds for accuracy.

  • Requires accurate balancing of all accounts.

Qualifica tions:

  • Requires a H.S. diploma or equivalent;

  • 2-4 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.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.