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Recovery Savings Analyst
CVS HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical claims processing, including adjustments and overpayment recovery, while effectively managing multiple assignments with accuracy and attention to detail. Proficient in conducting provider outreach and handling customer service inquiries to facilitate successful fund recovery.
Highest-signal resume keywords
Medical Claims ProcessingOverpayment RecoveryProvider OutreachCustomer Service InquiriesClaims Adjustments
About the role
Key responsibilities & impact- Recover and allocate overpaid dollars, including complex, non-routine refunds
- Manage overpayment inventory
- Partner with third-party vendors and internal business units
- Research and respond to recovery inquiries
- Conduct provider outreach, including outbound calls, to secure recoveries
- Review, collect, and resolve overpayment recovery items via phone and written correspondence
- Partner with internal business units, vendors, and liaisons to recover funds and allocate refunds
- Administer overpayment recovery policies and procedures
- Monitor inventory progress and complete timely follow-ups to achieve recovery goals
- Coordinate on escalated overpayments to drive resolution and recovery
- Analyze alternatives to solve complex, non-routine recovery issues
- Use reporting to track inventory, productivity, and recovery results
- Perform claim adjustments and rework calculations across all dollar amounts
- Apply medical necessity guidelines, determine coverage, verify eligibility, identify discrepancies, and apply cost containment measures
- Process complex provider refunds and returned checks
- Review and interpret provider contract language to validate overpayments and support refund-check allocation
- Deliver recovery training for less experienced team members as needed
- Handle assigned customer service inquiries and issues
Requirements
What you’ll need- 3+ years of medical claims processing experience
- 2+ years of medical claims adjustments and/or rework experience
- 2+ years of experience working in a fast-paced, deadline-driven, high-volume environment
- Experience conducting outbound calls, including provider outreach
- Experience handling customer service inquiries via phone and/or written correspondence
- Ability to interpret and apply guidelines related to eligibility, coverage, and benefits
- Demonstrated ability to manage multiple assignments with a high degree of accuracy and attention to detail
- Associate degree or equivalent experience
- Familiarity with refund posting
- Familiarity with overpayment recovery
- DG system claims processing experience
- Independent decision-making skills
- Effective communication, organizational, and interpersonal skills
Benefits
Comp & perks- CVS Health bonus, commission or short-term incentive program
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being, based on eligibility
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingOverpayment RecoveryRefund PostingRework CalculationsMedical Necessity GuidelinesEligibility VerificationCost Containment MeasuresInventory ManagementReporting and TrackingProvider Contract Interpretation
Soft Skills
Effective CommunicationOrganizational SkillsInterpersonal SkillsAttention to DetailIndependent Decision-Making
Tools & Technologies
DG System
Industry Keywords
Medical ClaimsRefundsRecovery InquiriesHigh-Volume EnvironmentDeadline-Driven