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Benefits Analyst II or III - #PS20626Location: United StatesRequisition #: PS20626Your 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.Benefits Analyst II or IIIOpen to most Anthem locations - must be within 50 miles of an Anthem office for a remote arrangementThe Benefits Analyst II or III will be responsible for identifying complex business needs and leading the benefit definition process with clients for Anthem commercial large group implementations. Primary duties may include, but are not limited to:
Meets with clients to obtain all benefit related requirements for commercial large group implementations.
Reviews, defines, creates and maintains all related benefit documents for the implementation (Benefit plan design, benefits strings, OBN, Blue exchange, etc.).
Research and analyze RFP proposals and research existing group benefit definitions when deviations occur and provide consultative feedback to existing groups with status reports in weekly client meetings.
Works with Account Managers to review SPDs and 2-pagers for Health Fairs.
Provides requirements for all related systems that interchange with benefits (BOA, OBN, etc.) Will provide technical support for post implementation research and correction of benefit issues.
Designs and builds new complex non-standard benefit plans, reviews and analyze benefit summaries; and identifies best approach to code/develop benefits to achieve optimum adjudication levels.
Maintains avoidance to negative financial, regulatory, and operational impact.
Performs testing and quality assurance of new product developed.
Create and maintain issue log on appropriate tool, resolve defects based on knowledge and analysis of system functionality.
Researches and responds to complex inquiries from various departments.
May consult with and mentoring of less experienced team members.
Serves as trainer for standard and highly customized benefit configuration.
Represents department in production related meetings including product development, design and implementation.
Must be able to perform all duties of lower level Benefits Analyst positions as directed by management.
Benefits Analyst II:Requires a High School diploma or GED; up to 3 years experience in claims processing, previous medical health care or analytical experience; 3-5 years benefit coding experience; or any combination of education and experience that would provide an equivalent background. BA/BS degree preferred.Benefits Analyst III:Requires a BA/BS degree in a related field; 3-5 years experience in claims processing, previous medical health care, analytical experience, or project management experience; 5 + years of benefit coding experience; or any combination of education and experience that 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.
