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Claims Resolution Analyst - PS33960Location: St. Louis, Missouri, United StatesNewRequisition #: PS33960Your 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 healthcare .This
is an exceptional opportunity to do innovative work that means more to you and
those we serve atone
of America's leading health benefits companies and a Fortune Top 50 Company.Claims Resolution AnalystOpen to most locations including a remote arrangementThe Claims Resolution Analyst will be responsible 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 member enrollment, provider information management, benefits configuration and/or claims processing.
Identifies the interdependencies of the resolution of claims errors on other activities within operations.
Assists in the reviews of state or federal complaints related to claims.
Coordinates the efforts of several internal departments to determine appropriate resolution of issues within strict timelines.
Interacts with network providers and health plans regularly to manage customer expectations, communicate risks and status updates, and ensure issues are fully resolved.
Performs claims and trend analysis, ensures supporting documentation is accurate and obtains necessary approvals to close out claims issues.
Requires a BA/BS; 3 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry; or any combination of education and experience, which would provide an equivalent background.Anthem, Inc. is ranked as one of America’sMost Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityIncmagazine Top 50 Company for Diversity. To learn more about our company andapply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
