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Financial Operations Recovery Specialist II,III (NASCO)- Multiple Locations (Remote) - PS21445Location: Indiana, United StatesNewField: Accounting/Finance/AuditingRequisition #: PS21445Your Talent. Our Vision. At Anthem, Inc ., it’s a powerful combination, and the foundation upon which we’re creating greater 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.Financial Operations Recovery Specialist II/IIIThis position may be filled at either the Financial Operations Recovery Specialist II or Financial Operations Recovery Specialist III level. Manager will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position.The Financial Operations Recovery Specialist II may do all or some of the following in relation to cash receipts, cash application, claim audits collections, overpayment vendor validation, and claim adjustments. Responsible for the discovery, validation, recovery, and adjustments of claims overpayments. 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.
The Financial Operations Recovery Specialist III may do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments. Responsible for the discovery, validation, recovery, and adjustments of claims overpayments. 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.
Financial Operations Recovery Specialist II
Requires a H.S. diploma; 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.
NASCO claims processing and adjustment experience required.
Experience with Networks/Pricing, Claim Xtend and COB a plus.
Proficient using Microsoft Excel, Outlook, Power Point, and Word strongly preferred.
Knowledge using WGS, Facets, Nasco, COR, ACR systems preferred.
Strong writing, presentation, research, analytical, problem solving, and verbal communication skills preferred.
Financial Operations Recovery Specialist III
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.
NASCO claims processing and adjustment experience required.
Experience with Networks/Pricing, Claim Xtend and COB a plus.
Proficient using Microsoft Excel, Outlook, Power Point, and Word strongly preferred.
Knowledge using WGS, Facets, Nasco, COR, ACR systems preferred.
Strong writing, presentation, research, analytical, problem solving, and verbal communication skills preferred.
This position is a remote/work from home position. You must live in one of the core locations listed, within 60 miles of an Anthem office.Core business locations IN, KY, OH, GA, CT, NH, ME, MO, WI, CO, NV, VA, CA. Must live with 60 miles of an Anthem office. Other locations may be considered.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 careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
Vacancy expired!