Anthem Medicaid Claims Resolution Analyst (Indiana HIPMedicaid Claims Experience) - Work From Home(Indianapolis Preferred) - PS11840 in Cape Girardeau, Missouri

Medicaid Claims Resolution Analyst (Indiana HIPMedicaid Claims Experience) - Work From Home(Indianapolis Preferred) - PS11840

Location: Indianapolis, Indiana, United States

Field: Claims

Requisition #: PS11840

Post Date: Aug 27, 2018

Your Talent. Our Vision . At Anthem Blue Cross and Blue Shield , a proud member of the Anthem, Inc. family of companies, 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.

Work Location: Remote; however, Indianapolis, IN is preferred.

The Claims Resolution Analyst is 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’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.