WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.Reimbursement Implementation Specialist II (US)
Job Family: Digital and Technology
Type: Full time
Date Posted:Mar 27, 2024
Anticipated End Date:Apr 26, 2024
Reference: JR101230
Location:
MA, WOBURN
OH, CINCINNATI
OH, MASON
GA, ATLANTA
GA, MIDLAND
NH, MANCHESTER
IN, INDIANAPOLIS
DescriptionPosition Title: Reimbursement Implementation Specialist IILocation: This position will work a remote model. The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.Reimbursement Implementation Specialist II provides accurate, timely maintenance of complex provider and reimbursement information.How you will make an impact:
Synchronizes data on claims and provider databases and provides expertise on business requirements for multiple business regions.
Identifies, analyzes, and resolves issues for multiple system provider databases.
Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.
Validates the data to be housed on provider databases and ensures adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. Researches and resolves complex exceptions and error reports.
Determines regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
Determines training needs and provides training to less experienced associates and outside customers on multiple provider data base systems and with multiple business requirements.
Minimum Requirements
H.S. diploma
Minimum of 3 years provider database experience; or any combination of education and experience, which would provide an equivalent background.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.Who We AreElevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.How We WorkAt Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.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.Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.EEO is the LawEqual Opportunity Employer / Disability / VeteranPlease use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.
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