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Process Expert I - Remote

Company: Anthem, Inc
Location: New Haven
Posted on: March 28, 2020

Job Description:

Process Expert I - Remote - PS31845Location: Mason, Ohio, United StatesNewRequisition #: PS31845Post Date: 23 hours agoYour Talent. Our Vision. At Anthem, Inc. , its a powerful combination, and the foundation upon which were 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.Process Expert I (Remote)This position will support member submitted paper claims processing function for Pharmacy Operations.Primary duties involve:

  • reviewing intake queue,
  • documents to enter claim relevant information to process claims.Responsibilities include:
    • reviewing and processing claims,
    • generating reject letters,
    • determining process improvement opportunities and identifying claims processing efficiency opportunities.
    • This candidate will have to interact with subject matter experts and other dependent stakeholders on a daily basis to perform their job duties.
    • Maintaining confidentiality of data is required.
    • Timely processing and reporting of claims is required.
    • Ensure daily processing targets are met.
    • Working with IT and leads to support business functional testing for changes/enhancements.QUALIFICATIONS
      • Requires a BA/BS degree;
      • 3 years related experience (business analysis, process improvement, claims operations) or any combination of education and experience, which would provide an equivalent background.
      • Pharmacy claims review/processing experience
      • Issue management experience (identifying, reporting issues and tracking them to closure)
      • Information Technology (IT) experienceAnthem, Inc. is ranked as one of Americas 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.

Keywords: Anthem, Inc, New Haven , Process Expert I - Remote, Other , New Haven, Connecticut

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