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 SeniorResponsible for
coordinating the resolution of claims issues by actively researching and
analyzing systems and processes that span across multiple operational
areas. Primary duties may include, but
are not limited to: Investigates and facilitates the resolution of claims
issues, including incorrectly paid claims, by working with multiple operational
areas and health plans and analyzing the systems and processes involved in
provider information management, pricing and benefits configuration and/or
claims processing. Identifies the
interdependencies of the resolution of claims errors on other activities within
operations. Coordinates the efforts of several internal departments to
determine appropriate resolution of issues within strict timelines. Interacts
with submitting partners regularly to manage customer expectations, communicate
risks and status updates, and ensure issues are fully resolved. Responsible for
the research, analysis and root cause determination on high complexity claims
inquiries and provider appeals. Will also support team development activities,
knowledge sharing and escalation support of their colleagues through the review
of assigned internal question subtasks, training and team discussion as needed.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: PS36800-US
Vacancy expired!