Vacancy expired!
Medicaid State Operations Analyst - (Remote) Any Anthem location PS21592Location: United StatesNewField: ClaimsRequisition #: PS21592Your 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.Location : This position is Remote from Home in any state that has an Anthem office (including our subsidiaries). The work hours are 8:00 am - 4:00 pm Central Time, regardless of your location.Responsible for researching, analyzing, documenting and coordinating the resolution of escalated and/or complex claims issues for the Health Plan and requires expert knowledge of all systems, tools and processes.Primary duties may include, but are not limited to:
Receiving and responding to state or federal regulatory complaints related to claims, billing and payment issues.
Managing health plan dispute escalations.
Quality review of various dispute outcomes.
Managing complex system issues.
Managing state updates.
Collaborate with internal teams to ensure provider groups are appropriately configured.
Requires a BA/BS; and
5 years’ experience in claims research and/or issue resolution or analysis within the health care industry; or any combination of education and experience, which would provide an equivalent background.
Medicaid operations and/or Managed Care experience is preferred.
Knowledge of ICD 10 coding is preferred.
Understanding of CPT coding, diagnosis coding, modifiers, and Coordination of Benefits is very helpful.
Proficiency in Microsoft Excel is 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!