Description SHIFT: Day Job SCHEDULE: Full-time Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change.
Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.
Serves as subject matter expert regarding reimbursement policies, edits, and coding conventions.
Primary duties may include, but are not limited to: Works with vendors and enterprise teams to develop enterprise reimbursement policies and edits, ensuring policies and edits do not conflict with Federal and state mandates.
Works with other departments on claims adjudication workflow development and business process improvements.
May lead the full range of provider reimbursement activities for a state(s).
Leads projects related to provider reimbursement initiatives.
Serves as a mentor to less experienced administrators.
This position is 100% remote.
The candidate selected for this role can work anywhere in the US.
Qualifications Minimum Qualifications: Requires a BA/BS degree and a minimum of 4 years related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualification RN strongly preferred.
Medical billing and coding certification strongly preferred 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.
The health of our associates and communities is a top priority for Anthem.
We require all new candidates to become vaccinated against COVID-19.
If you are not vaccinated, your offer will be rescinded unless you provide and Anthem approves a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate.
Anthem will also follow all relevant federal, state and local laws.
Anthem, Inc.
has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 Worlds Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion.
To learn more about our company and apply, please visit us at careers.antheminc.com.
Anthem 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 abilityicareerhelp.com for assistance.
REQNUMBER: PS72352-Texas