Overpayment Recovery Specialist Jobs (NOW HIRING)

Job Summary
Supervise the day-to-day claim overpayment recovery operations and support a team responsible for maximizing recoveries through claim offsets, cash collections, wire transfers, and other electronic payment methods. This role works closely with internal business and technical partners to ensure the accurate management, recovery, allocation, and reporting of claim overpayment receivables while maintaining compliance with established financial controls and operational procedures.
The Supervisor is responsible for overseeing daily recovery activities, monitoring receivable inventories, managing payment allocation processes, and ensuring the timely resolution of outstanding claim overpayments across multiple claims and financial systems. This position provides leadership, coaching, and operational guidance to staff while supporting departmental goals, service levels, and recovery performance objectives.
Working collaboratively with Claims, Finance, Cash Application, Provider Customer Service, Compliance, and Technology teams, the Supervisor identifies operational challenges, supports process improvements, analyzes recovery trends, and helps implement solutions that improve efficiency, accuracy, and customer experience. Through strong team leadership, data-driven decision making, and a focus on continuous improvement, this role contributes to reducing aging receivables, strengthening financial controls, improving payment allocation accuracy, and enhancing recovery outcomes for providers, customers, and members.
The ideal candidate combines operational expertise, analytical skills, and people leadership to drive performance, ensure compliance, and support the ongoing success of the claim overpayment recovery function.
Responsibilities
• Support the successful execution of departmental goals by fostering effective collaboration and communication among internal stakeholders involved in claim adjudication, overpayment recovery, and payment processing activities.
• Supervise the daily operations of the claim overpayment recovery and payment allocation functions, ensuring accuracy, efficiency, timely recoveries, and adherence to established procedures.
• Build and maintain strong working relationships with internal business partners and external stakeholders to support operational objectives, reporting needs, and process improvements.
• Monitor operational workflows, identify issues and bottlenecks, and implement corrective actions to improve performance, productivity, and service levels.
• Ensure compliance with internal financial controls, operational policies, and audit requirements to maintain the integrity of claims-related financial transactions and reporting.
• Coach, develop, and support team members through ongoing performance management, training, mentoring, and professional development opportunities.
• Analyze recovery trends, payment activity, and operational metrics to identify risks, opportunities, and areas requiring management attention.
• Support compliance with applicable federal and state regulations, contractual obligations, and company policies related to claim overpayments, recoveries, claim adjustments, provider communications, and collection activities.
• Partner with business and technology teams to support automation initiatives, system enhancements, testing activities, and the implementation of process improvements.
• Prepare and communicate operational updates, performance metrics, project status reports, and key business insights to management and stakeholders.
• Provide day-to-day leadership and guidance to recovery specialists and analysts, ensuring work is completed accurately, timely, and in accordance with departmental standards.
• Collaborate with vendors and external business partners to resolve operational issues, improve recovery processes, and maximize collection opportunities.
• Oversee recovery operations across multiple systems and platforms, ensuring consistent application of recovery policies and procedures.
• Work closely with Claims, Finance, Cash Application, CFID, Provider Customer Service, and other operational areas to support effective management of claim receivables and recovery activities.
• Monitor claim overpayment receivables throughout the recovery cycle and escalate issues as appropriate to maximize recovery outcomes and minimize aging balances.
• Assign, review, and oversee the allocation, reconciliation, and application of high-volume recovery payments received through various payment channels and cash management systems.
• Develop and distribute reports that provide visibility into payment allocation activities, recovery performance, inventory management, and operational results.
• Recommend process improvements by evaluating current workflows, policies, procedures, and system functionality to enhance efficiency, accuracy, and service delivery.
• Utilize data analysis, reporting tools, and operational metrics to support decision-making, workload management, and continuous improvement efforts.
• Promote a culture of accountability, teamwork, customer service, compliance, and continuous improvement while recognizing and reinforcing strong performance.
• Assist management with workforce planning, workload balancing, resource allocation, and the achievement of departmental performance goals and service-level commitments.
Required Qualifications
• Bachelor's degree in Business Administration, Finance, Accounting, Healthcare Administration, or a related field.
• 3 to 7 years of experience in claim processing, overpayment recovery, accounts receivable management, financial operations, or related healthcare operational functions.

• Demonstrated knowledge of claim adjudication, provider overpayments, payment recovery processes, receivable management, and healthcare claims operations.
• Strong analytical and problem-solving skills with the ability to interpret data, identify trends, and develop actionable recommendations.
• Experience supervising or leading operational teams, including coaching, performance management, workload distribution, and employee development.
• Ability to prioritize multiple responsibilities and make sound decisions in a fast-paced, deadline-driven environment.
• Proven experience supporting process improvement initiatives and implementing operational efficiencies.
• Strong collaboration and relationship-building skills, with the ability to work effectively across all levels of the organization.
• Excellent verbal and written communication skills, with the ability to present operational results, challenges, and recommendations to leadership and stakeholders.
• Proficiency with claims processing systems, receivable management platforms, and financial reporting tools.
• Strong organizational and time-management skills, with attention to detail and a commitment to operational excellence.
• Ability to work independently while maintaining a high degree of accountability and ownership.
• Experience utilizing reporting and data analysis tools to monitor operational performance and support decision-making.
• Working knowledge of state and federal regulations governing healthcare claims, overpayments, recoveries, collections, and financial controls.
• Intermediate to advanced proficiency in Microsoft Excel, including data analysis, reporting, and reconciliation functions.

Preferred Qualifications

• Experience within a healthcare payer, managed care, health insurance, or provider accounts receivable environment.
• Experience with data visualization and business intelligence tools such as Tableau, Power BI, or similar reporting platforms.
• Knowledge of healthcare financial systems, cash management platforms, and payment allocation processes.
• Demonstrated success leading process automation, workflow improvements, or system enhancement initiatives.
• Experience managing teams of 5 to 10 associates in a production-focused operational environment.
• Ability to leverage data analytics and operational metrics to improve recovery performance, reduce aging receivables, and enhance operational efficiency.
• Proven track record of driving continuous improvement, fostering employee engagement, and achieving departmental performance goals.
• Experience working with cross-functional teams including Claims, Finance, Cash Application, Provider Services, Compliance, and Information Technology.

Core Competencies

• Leadership & Team Development
• Claims Recovery & Receivable Management
• Financial Controls & Compliance
• Data Analytics & Reporting
• Process Improvement & Automation
• Operational Excellence
• Strategic Problem Solving
• Stakeholder Management
• Customer & Provider Focus
• Communication & Collaboration
• Change Management
• Results Orientation

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.