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External Performance Audit Coordinator - FHPS - PS33883Location: Cincinnati, Ohio, United StatesNewRequisition #: PS33883Your Talent. Our Vision. At Federal Health Products and Services - FHPS , 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.External Performance Audit Coordinator – Option to work remotely near any of the listed FHPS Anthem locations: South Portland, ME; Albany, NY; Roanoke, VA; Midland, GA; Cincinnati, OH; Indianapolis, IN or Reno, NV.Responsible for conducting and coordinating external quality performance audits which are administered based on mandatory guidelines published by the BCBSA. Primary duties may include, but are not limited to:Reviews, evaluates and verifies the quality of claims adjudication, and customer service transactions.Renders non-biased and ethical decisions while assuring compliance with BCBSA Plan Incentive Program guidelines.Performs in-house training as needed.Compiles and reports audit results to internal corporate management, executive management, Operations areas, Quality Assurance coordinators and other outside groups as required.Validates sampling methodology and contents of data reports.Ability to easily adapt by change in assignment working Enterprise-wide in any one of 14 states.Requires B.A. or B.S. degree; minimum 23 years auditing experience, or any combination of education and experience, which would provide an equivalent background.Must demonstrate knowledge of regulations related to specialized functions.Previous experience with Federal Health Products & Services is highly recommended.Previous auditing experience strongly preferred.Previous claims and/or customer services experience preferred.Skilled in negotiation, communication in both verbal and written, investigation and research 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!