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G&A Audit Specialist-PS30172Location: California, United StatesNewRequisition #: PS30172Your 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.Grievance and Appeals Audit Specialist-Remote in CA, NV, TX, KS, WA, CO, or NEResponsible for Medicaid Grievances & Appeals audit preparation activities that include the presentation of case specifics to the external entity auditing Anthem. Primary duties to include, but are not limited to:
Manage and oversee external audit requests and delegated entity functions for Grievance & Appeals.
Interpret audit requests and prepare comprehensive responses.
Support and participate in planning, executing, and facilitating audits/audit requirements.
Based on audit findings/review, participate in root cause analysis, process improvement and communication activities on behalf of G&A.
Requires:
Bachelor's degree and 2-3 years related experience
or the equivalent combination of education and experience.
Good analytical and problem-solving skills required.
Excellent oral and written communication skills necessary.
Strong organizational skills required
Must be proficient in Excel, SharePoint, and Word
Must be proficient in multi-system manipulation
Familiarity with state specific Medicaid regulations preferred
Previous experience in auditing strongly preferred
Compliance, Grievance and Appeals analysis, or data analysis experience preferred
Up to 25% travel 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.
