Fin Ops Recovery Spec I (PHL) at Elevance Health

Taguig City, National Capital Region, Philippines

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

H.S. diploma
1-2 years of claims processing and/or customer service experience (or any combination of education and experience providing equivalent background)
Associate degree preferred

Responsibilities

Setting up and adjusting claims overpayments that have been previously identified
Reviewing and validating paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research
Determining and calculating amount of overpayments and processing refunds
Researching voluntary refunds for accuracy
Accurately balancing all accounts
Handling more routine issues
Working with internal staff from other departments to ensure customer satisfaction
Performing collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable balances and all other cash applications
May handle cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments

Skills

Key technologies and capabilities for this role

claims processingcash applicationclaim auditscollectionsoverpaymentsrefundscustomer servicesystem queriesspecialized reportingaccount balancing

Questions & Answers

Common questions about this position

What is the shift schedule for this position?

The shift is from 6:00 AM to 3:00 PM (Philippines time).

What are the minimum education and experience requirements?

A high school diploma is required along with 1-2 years of claims processing and/or customer service experience, or equivalent combination of education and experience. An associate degree is preferred.

What are the primary responsibilities of this role?

The role involves reviewing and validating paid claims for overpayments, calculating and processing refunds, researching voluntary refunds, balancing accounts, and performing collection activities to recover overpayments.

Is this a full-time position?

Yes, this is a full-time employment position.

What salary or compensation does this role offer?

This information is not specified in the job description.

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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