Fin Ops Recovery Spec II or III (Any WellPoint Location or OPW) - 64085
WellPoint - Louisville, KY

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WellPoint is one of the nations leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are dedicated to improving the lives of the people we serve and the health of our communities. WellPoint strives to simplify the connection between health, care, and value for our customers.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

Our Fin Ops Recovery Specialist m ay 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.

Job Qualifications

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. Claims experience required. Recovery experience/COB a plus. Claims background/recovery background on the Virginia processing systems, CHIP and/or AMISYS preferred.

WellPoint is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2012 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at www.wellpoint.com/careers. EOE

Once an offer is accepted, all external applicants are subject to a background investigation
and if appropriate, drug testing. Offers of employment shall be contingent upon
passing both the background investigation and drug testing (if required).

  • Current WellPoint associates: All referrals must be submitted through the formal
associate referral process on WorkNet. Official guidelines for the associate referral
program can be found in My HR.

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WellPoint, Inc. (WellPoint) is a health benefits company serving 35 million medical members, as of December 31, 2008. The Company is an...