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Role Description

The Financial Operations Recovery Specialist I is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures.

• Participate in claims workflow projects.
• Respond to telephone and written inquiries and initiate steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims.
• Adjust voids and reopen claims online within guidelines to ensure proper adjudication.
• May have customer/client contact.
• May assist with training of staff.
• Works without significant guidance.

Qualifications

• Requires a HS diploma and a minimum of 3 years of the company's internal claims experience; or any combination of education and experience which would provide an equivalent background.

Requirements

• Government claim processing experience STRONGLY preferred.
• TS Home and/or Host experience preferred.
• Claim Adjustment experience preferred.
• Demonstrated ability to work independently, prioritize workload, and take ownership of daily deliverables with minimal supervision.
• Strong ability to read, interpret, and accurately apply documented policies, procedures, and processing steps to ensure compliant, consistent outcomes.
• Flexibility to shift between work types (e.g., queues, outreach, research, corrections) and adapt quickly to changing priorities while maintaining production and quality standards.
• High attention to detail and accuracy when reviewing financial information, resolving discrepancies, and documenting actions in required systems.
• Effective time management and organization skills to meet deadlines and service-level expectations in a high-volume environment.

Benefits

• Market-competitive total rewards including merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
• Medical, dental, vision, short and long term disability benefits.
• 401(k) + match.
• Stock purchase plan.
• Life insurance.
• Wellness programs and financial education resources.