Anticipated End Date:

2025-09-03

Position Title:

Financial Operations Recovery Process Specialist

Job Description:

Financial Operations Recovery Process Specialist

Hybrid 1: This role requires associates to be in-office 1 - 2  days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Financial Operations Recovery Process Specialist is responsible for providing technical direction, guidance and resources to associates on a day to day basis. 

How you will make an impact:

Serves as a first line resource for financial operations associates for workflow and technical related processes.

Provides operational training, assists associates by answering day-to-day technical questions, monitors inventory to ensure workflow remains uninterrupted, and handles complex case research and resolution.

May review and monitor associates work for quality standards. Reviews department policy and procedure manuals for accuracy and works to ensure procedures and policies are accurate and complete.

May research operations workflow problems and system irregularities.

Assists with the development and testing of process improvement solutions and other operational improvements.

Minimum Requirements:

Requires a BA/BS and minimum of 3 years related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

3-5 years GBD Facets processing and adjustment experience strongly preferred.

Prior experience working with automated financial systems and/or data systems strongly preferred.

Experience working post-pay reviews, validation, and recovery processes in the healthcare industry strong preferred.

Experience managing multiple projects in various stages to completion strongly preferred.

Experience with medical billing guidelines, and regulations preferred.

Experience with medical coding systems such as ICD, CPT, and HCPCS strongly preferred.

Claim processing and adjustment experience strongly preferred.

Previous experience in high-volume operations (claims, customer service, enrollment and billing) strongly preferred.

Job Level:

Non-Management Non-Exempt

Workshift:

1st Shift (United States of America)

Job Family:

AFA > Financial Operations

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.