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CAREERS ANTHEM TECHNOLOGY CENTERS ABOUT ANTHEM IT

Grievance/Appeals Analyst I - Miami, FL - PS19321

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Claims
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PS19321 Requisition #
Thanks for your interest in the Grievance/Appeals Analyst I - Miami, FL - PS19321 position. Unfortunately this position has been closed but you can search our 1,077 open jobs by clicking here.
  • High school diploma or GED.
  • 3 to 5 years experience working in grievances and appeals, claims, or customer service; or any combination of education and/or experience which would provide an equivalent background.
  • Familiarity with medical coding and medical terminology.
  • Demonstrated business writing proficiency.
  • Understanding of provider networks, the medical management process, claims process, the company's internal business processes, and internal local technology.
  • WGS experience is preferred. 
  • CS90 and ECC experience is preferred.
  • Extensive research skills is preferred. 
  • Experience with documentation and process improvement preferred.
  • NextGen/PEGA experience a plus.
  • For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

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

Simply Healthcare Plans is a Florida managed health care provider that serves Medicare and Medicaid members. Through our Clear Health Alliance organization, our health plan also serves Floridians who are eligible for HIV/AIDS Medicaid specialty health plan services. Along with our sister plan, Amerigroup Florida, we serve more than 600,000 Floridians who are members of our Medicare and Medicaid plans. Across the nation, our family of health plans serves nearly 40 million members, and 1 in 8 Americans is served by our family of companies. Our health plan members are assured care that is not only accessible, but also accountable, comprehensive, integrated and patient-centered. Each and every day, members of our team can be found in Florida communities, listening to our members, interacting with our health care providers and partnering with community-based organizations to execute health education initiatives. Our goal is to ensure members and entire communities are empowered to become active participants in their health care and sustain healthy lifestyles. To learn more about Simply Healthcare Plans, visit www.simplyhealthcareplans.com.

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