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Dental Services Analyst- Newbury Park, CA- PS28501Location: Newbury Park, California, United StatesNewRequisition #: PS28501Your Talent. Our Vision. At Anthem, Inc., 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 atone of America's leading health benefits companies and a Fortune Top 50 Company.Dental Services AnalystResponsible for the analysis of dental claims, radiographs, patient histories and other records to ensure consistent application of and compliance with policy and departmental guidelines.Primary duties may include, but are not limited to:
Identifies and reports on typical patterns of care.
Acts as a liaison between consultants, providers, members and operational departments to resolve unusual problems and complex cases.
Makes independent decisions regarding benefit eligibility, including exceptions to policy as warranted.
Provides expert analysis and testimony to corporate appeals and grievances.
Coordinates utilization review, including scheduling consultants to ensure timeliness.
Reports savings and recommends procedural and policy changes to maintain or increase revenue.
Requirements
Requires a BA/BS;
2 years of experience; or any combination of education and experience, which would provide an equivalent background.
Current Registered Dental Assistant (RDA) license required.
Dental Radiology and Coronal Polishing certification required.
Detailed knowledge of dental procedures, coding and contracts required.
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!