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Description SHIFT: Day JobSCHEDULE: Full-timeYour 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.This is a remote opportunity, open to any state. Selected candidate must live with in 50 miles of an Anthem facility. This position will support East Coast hours of 11:30 am to 8:00 pm ET, regardless of location.The Transplant Benefit Specialist is responsible for ensuring accurate transplant benefit administration. Interfaces daily with providers and members to resolve benefit issues and provide education where needed. Responsible for analyzing components of benefits and alerting management of risks. Primary duties may include, but are not limited to:
Interprets benefits and interfaces with members and providers to give benefit information.
Prepares individual benefit quotes for members and providers for transplant benefits.
Identifies high risk cases and alerts management.
Interfaces with internal and external representatives on benefit issues.
Creates new cases in the Medical Management System with accurate benefit, group and provider information.
Creates Case Management Folders and determines initial acuity level of case.
Qualifications Requires:
High School diploma; 3-5 years related experience; knowledge of health benefits, medical terminology, ability to work and make independent decisions timely and accurately; good customer service skills, including conflict resolution; or any combination of education and experience, which would provide an equivalent background.
Utilization Management experience preferred.
Customer Service Call Center experience preferred.
Proficiency with Microsoft Office (Outlook, Excel and Word).
Ability to multi-task, detail-oriented, and strong organization skills required.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.REQNUMBER: PS37435-US
