Overpayment Recovery Analyst – Employee Benefits

Role Overview

• Conduct thorough review of claim referral to validate overpayment and ensure financial accuracy.
• Utilize data science tools to detect discrepancies and proactively seek out overpayment recovery opportunities.
• Collaborate with internal claim partners to coordinate additional investigations as needed.
• Execute strategic plans for overpayment recovery that are aligned with organizational goals and impact the company’s bottom line.
• Develop and implement strategies for recovering overpaid amounts from clients, vendors, and other parties.
• Negotiate repayment plans and settlements, ensuring compliance with company policies and legal requirements.
• Utilize data dashboards to monitor recoveries and other key performance metrics.
• Effectively manage a high-volume case load and maintain timely follow up communication to ensure accurate resolution.
• Deliver exceptional customer service by balancing empathy and efficiency.
• Participate in problem solving discussions and facilitate the implementation of process improvement.
• Utilize advanced data analytics to identify root causes and patterns of overpayments and recommend improvements to prevent future occurrences.
• Document and update standard operating procedures related to overpayment identification and recovery.
• Stay current on industry trends, best practices, and emerging technologies in overpayment recovery and Group Benefits.
• Serve as the primary point of contact for internal and external business partners regarding overpayment issues.

Requirements

• Understanding of Group Benefits claims and the leading indicators of an overpayment preferred.
• Proficiency in Group Benefits claim systems including DCS, THAA and PeopleSoft is preferred.
• Consistent high level of performance and achievement over career span.
• Candidate should demonstrate the ability to exceed metrics and be motivated to achieve high personal achievement.
• Ability to build successful relationships with our field partners and claimants.
• Candidate should exhibit strong desk management skills and the ability to work in a fast-paced environment with a proven track record of delivering results.
• Excellent interpersonal skills and professional writing skills to clearly communicate and negotiate with claimants and attorneys in a professional demeanor.
• High School diploma/GED
• Bachelor’s degree or equivalent experience is strongly preferred
• 2 + years of prior claim or collections experience

Benefits

• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off
• Professional development opportunities
• Bonuses
• Employee recognition programs