Anthem, Inc. Financial Operations Recovery Specialist II, III in Springfield, Missouri
SHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and 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 at one of America's leading health care companies and a Fortune Top 50 Company.
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. • 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 policies 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. • Research voluntary refunds for accuracy.
• Requires accurate balancing of all accounts.
• Requires a H.S. diploma/GED
• Associate degree or higher-level degree preferred.
• 3-5 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.