Vacancy expired!
Description SHIFT: Day JobSCHEDULE: Full-timeYour 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.Provider Configuration Analyst LeadResponsible for
the research, analysis and root cause determination on priority/high visibility
inquiries with shortened turnaround times such as State Complaints, CERT and Quest
Audit validation. Involved with team development, workload/resource management,
triage and escalation support. Responsible for guiding the team in either a
technical or non-technical capacity through the completion of their assigned
tasks/inventory. This role (both technical and non-technical) has increased
visibility with departmental leadership and external partners and their
leadership, in an effort to ensure growth in leadership opportunities.
Associates in this role will serve as a focal point to communicate and resolve
interface/integration issues with other teams on behalf of CRCT. Primary duties include
researching, analyzing, documenting and coordinating the resolution of
escalated and/or complex claims issues that span across multiple operational
areas and requires expert knowledge of all systems, tools and processes.
Assists in the reviews of state or federal complaints related to claims.
Provide project team leadership, support, assign work and manage inventory.
Coordinate the identification and resolution of root causes involving
configuration. Performs global observation and trend analysis and coordinates
with cross-functional teams to prevent future recurrence of configuration
errors identified. Qualifications BA/BS degree;
2-4 years related experience; 3 years of claims research and/or issue
resolution or analysis of reimbursement methodologies within the health care
industry. Any combination of education and experience, which would provide an
equivalent background. Advanced critical thinking/analytical/ problem solving
skills required. FACETS, QNXT or WGS experience required. SQL, SAS or Access
experience required; the ability to query and build reports. Experience
communicating and presenting data to various audience members at all levels
required. Experience facilitating meetings preferred. Legacy system experience
preferred (CS90, ACES, CHIPS, Central Region Facets, NASCO, FEP, Price N Ship).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.REQNUMBER: PS36799-US
Vacancy expired!