Anthem Inc. Virginia Jobs

Job Information

Anthem, Inc. Provider Pay Reconsider Analyst I in Norfolk, Virginia

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your 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 care companies and a Fortune Top 50 Company.

Location: Remote; incumbent must live within 50 mile radius to the following Anthem Offices - Mason OH, Miami FL, Tampa FL, Norfolk VA

Start Date: Intended start date for this position is Monday, January 31, 2022

The Provider Pay Reconsider Analyst I supports the Payment Dispute process across all lines of business and is specifically responsible for the resolution of Provider Payment Reconsideration requests.

Primary duties include, but are not limited to:

  • Reviews and analyzes provider requests to investigate the outcome of claim payment or denial.

  • Determines the appropriate resolution using strict adherence to internal guidelines, policies, and procedures.

  • Must work with various departments, when necessary, to determine root cause and appropriate resolution.

  • Must remediate impacted claims.

Qualifications

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid-19. All offers of employment are conditioned on completion of a background check, including COVID-19 vaccination verification. If you are not vaccinated, your offer will be rescinded unless you provide –and Anthem approves –a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.

  • Requires a HS diploma or GED and a minimum of 3 years experience working in claims or customer service; or any combination of education and experience which would provide an equivalent background.

  • Familiarity with medical coding and medical terminology, demonstrated business writing proficiency, understanding of claims process, and the company's internal business processes and technologies preferred.

  • Medicare Advantage claims processing experience preferred

  • Experience reviewing and reprocessing Medicare claims preferred

  • Experience with company relevant automated processing systems such as GBD Facets, WGS, and Macess preferred

    We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

    REQNUMBER: PS63711-Norfolk-Norfolk

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