Recovery Analyst

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Pursue the recovery and allocation of overpaid dollars, and non-routine and complex refunds. Manage, monitor, and work overpayment items. Partner with third-party vendors, research and respond to recovery inquiries. Make outbound calls to providers; track and conduct follow-ups to recover funds. Collaborate with key business functions on escalated overpayments to coordinate recovery efforts. May handle customer service inquiries and problems. Fundamental Components Review, collect, and resolve overpay or recovery conflicting, missing or inaccurate information via telephone or written correspondence with limited degree of supervision. Partner with internal customers/business units, third party vendors, and liaisons to recover and fully allocate refunds. Administer overpayment recovery policy and procedures, telephone and written correspondence to members, providers, and other insurers. Manage overpayment work; collaborate and conduct provider outreach to achieve business goals. Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures. Use a systematic approach in solving problems through analysis and evaluation of alternate solutions. Utilize available reports to track inventory and recovery results. May deliver recovery training programs for less experienced team members. Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise. Applies medical necessity guidelines, determine...