Auditor and Recovery Specialist

We are looking for bright and energetic individuals to be an Auditor and Recovery Specialist.  


  • Auditing processed claims and providing feedback to the processors
  • Analyzing auditing results for trends and identification of areas where additional training may be needed
  • The recovery of overpaid claims through refund request or recoupment
  • Reporting potential re-insurance claims and filing actual claims
  • Complete review of processed claims, tracking the necessary details to provide feedback to the processors on correct/incorrect claim handling as well as provide monthly statistics on a procedural and financial basis
  • Request refunds via written request or recoupment of overpaid claims, as directed by the client
  • Maintain logs of refunds and recoupment’s as well as refund checks received and processed
  • Process refund checks in claim system according to guidelines
  • Send follow-up requests on outstanding overpayments at required intervals
  • Request and review monthly reports for potential re-insurance claims and report to client
  • File re-insurance claims when limits reached on potential reports
  • Serve as back-up for check run process
  • Assist in claim query write-up’s within the claim paying system
  • Other duties as assigned


  • Extensive experience in health insurance claims processing with a minimum 5 years experience
  • HMO Claims or managed care environment preferred

Valence Health is an equal opportunity employer welcoming diversity in our workforce!

This is a continuous recruitment to identify candidates for our Auditor and Recovery Specialist position.