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Freedom Health Network Directory Specialist Sr - Tampa, FL - PS30336Location: United StatesNewRequisition #: PS30336Your Talent. Our Vision. At America’s First Choice , a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care .This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.Position: Network Directory Specialist Sr.Location: Tampa, FLResponsible for the production and submission of timely and accurate paper/electronic directory production files. Handles review and implementation of changes to directory production and network verification processes to remain in compliance with CMS Guidelines and NCQA requirements.Primary duties may include, but are not limited to:
Produces directory on a monthly basis, including corrections to covers and prefaces to ensure 508 compliance.
Conducts outbound calls to obtain, validate providers’ information.
Daily QA of provider network.
Validates, audits and corrects both format and data of transmitted provider files.
Generates responses to CMS and NCQA audit requests.
Quarterly processing of the Hospital Accreditation reports to be uploaded to the plan website.
Assigns cases to be worked by in-house and field reps based on findings from outbound verification calls.
Produces, in a timely manner, GEO reports and Disruption Analysis reports and departmental documentation of directory/report business requirements and system processes.
Requires a H.S. diploma; 2-3 years of provider directory files experience; or any combination of education and experience, which would provide an equivalent background. Experience with SAS or Access preferred.Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
Vacancy expired!