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Our Customer Care Representatives are making a difference in members' lives every day.

As a Customer Care Representative you will guide members through their healthcare experience, answer customer questions via phone, e-mail, or chat; or help providers with questions about member plans. You will be the person that members can rely on to help them navigate their healthcare needs by explaining their benefits, solving claim concerns, finding a doctor nearby or being their healthcare advocate. You will be their guide to a better healthcare experience by being proactive, anticipating next steps, and ensuring that they only need to call once to get the help they need.

Here's what a typical day may look like:

  • From the moment you login, you'll be focused on answering customer calls, demonstrating our values as you proactively work to resolve our members' questions and concerns
  • You'll strive for first call resolution, working to resolve member issues at the point of contact
  • Using dual monitors and leveraging computer based resources you'll find answers to customers questions, and help simplify next steps for members without giving them homework
  • Acting as an advocate for our members, you may reach out to partners in other departments, or to Doctor's office to help resolve a customer need or concern
  • You will be constantly learning, growing your knowledge and skills, and embracing new technology as we continue to evolve how we service our customers

Competitive Pay

  • Anthem offers competitive pay and quarterly bonus incentives based on individual and departmental performance.
  • Opportunities for Overtime
  • Annual increases based on performance
  • Special recognition programs and other incentives

8 Paid Holidays

Anthem recognizes the following holidays: New Year's Day, Martin Luther King Jr. Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Day after Thanksgiving, and Christmas Day.

Paid Time Off

Our PTO program offers you the flexibility to take time off for vacation, personal or family illness, or other personal or family needs while balancing meeting the needs of our customers.

Paid Paternity Leave & New Parent Transition Week

Our new Paid Parental Leave provides fathers and mothers with up to four consecutive weeks of paid leave after the birth or adoption of a child.

Health Benefits

We offer a comprehensive benefits package to meet everyones different needs. This includes excellent Health Insurance, Dental, Vision, Short Term Disability, Long Term Disability, Critical Illness, Accidental and Basic Life.

401K Match

Anthem has an outstanding 401(k) plan and match program. Through the 401(k) plan, both you and Anthem contribute to help build the foundation of your financial future. The plan allows you to save for retirement by setting aside eligible earnings from your paycheck on either a traditional pre-tax basis, or an after-tax Roth 401(k) basis, or any combination of the two. Anthem then matches your contributions up to a total potential match of 4.5%.

Employee Discount Program

Anthem offers access to employee discounts for many things from tickets, car rentals, and travel, to restaurants, car insurance, electronics and other merchandise.

Employee Stock Purchase Plan

Anthem offers associates the employee stock purchase plan (ESPP), which gives associates the opportunity to purchase Anthem stock at a discount through convenient payroll deductions.

Career Path Opportunities

Anthem has incredible career advancement opportunities. Many of our trainers, quality coaches, managers and leaders also began their careers as Customer Care Representatives. Managers evaluate you based on your skills, behaviors and performance for readiness for promotional opportunities as early as 9 months after you begin.

Development Opportunities

Anthem provides many development opportunities within your job, as well as access to learning resources such as: online courses, videos, professional certification and leadership development programs to support your professional and career development.

Education Assistance

Anthem encourages associates to pursue learning opportunities at accredited institutions toward the completion of under-graduate and post graduate degrees, and will reimburse full time associates for up to $5,000 in eligible expenses ($2,500 for part-time). You can earn your bachelors degree on us, through Anthem's partnership with Southern New Hampshire University - College for America program, a project based learning program designed for busy working adults.

Values in Action

This recognition program lets managers award a cash or noncash incentive. Cash incentives range from $25 to $5,000.

Wellness Center

Anthem supports you in your efforts to get and stay healthy by offering a wide range of wellness programs, an onsite fitness center, healthy food subsidies in our onsite cafeterias, onsite flu shots and health screenings, and subsidized Weight Watchers® subscriptions.

Community & Volunteerism

Anthem offers associates an inclusive and collaborative culture where everyone feels welcomed and respected. We also encourage you to volunteer within the community for your favorite nonprofit by giving you up to 8 hours per year of volunteer time off to work with eligible 501c3 public charities.

Associate Resource Groups

Our nine associate resource groups (ARGs) are formed around common interests, backgrounds and/or different aspects of diversity.

Through their work and influence, our ARGs offer:

  • Professional and personal development
  • Different perspectives and innovative ideas
  • Opportunities to connect culture to business decisions

Many of our locations have onsite fitness centers, cafeterias or mini marketplaces, and game rooms for use during breaks. We also offer free onsite parking even in our downtown locations.


  • Indianapolis, IN Corporate Office, L. Ben Lytle Center
  • Midland, GA
  • Tampa, FL
  • Denver, CO
  • Las Vegas, NV
  • Richmond, VA

Other large Anthem Call Center locations:

  • Tampa, FL
  • Mason, OH
  • Nashville, TN
  • Houseton, TX
  • Middletown, NY
  • Roanoke, VA
  • Fond du Lac, WI
  • Newbury, CA
  • Woodland Hills, CA
  • Rancho Cordova, CA
  • *This is not an exhaustive list of Anthem locations or amenities. Certain amenities may differ by location.

We view interviewing and the employment decision as a two way street, which begins with our Virtual Job Tryout.

The Virtual Job Tryout gives you a chance to gain some insight into what the job of a Customer Care Representative, and gives us the opportunity to assess your skills.

For the interview, we utilize a behavioral interview process to learn more about how you would approach scenarios, and gain insight into your experience. We invite you to also come to the interview with questions for us.

Before beginning background checks, we will let you know we are interested in extending an offer to you and discuss new hire class start dates.

*Sign-On Eligible - Physician Drug Program (PDP)/Pharmacist Program Mgr - NC license required (PS28492)

📁
Medical
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PS28492 Requisition #
Your Talent. Our Vision. At Healthy Blue,  a subsidiary of Amerigroup, an Anthem Inc. company,  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 benefits companies and a Fortune Top 50 Company.

*Sign-On Eligible - Physician Drug Program (PDP)/Pharmacist Program Mgr - NC license required (PS28492)

Summary: Responsible for supporting the implementation and maintenance of the Healthy Blue PDP Program. This individual will be responsible for maintaining program requirements as directed by NC DHHS, working with internal stakeholders to update the medical claims system configuration, develop and maintain the case-by-case review process, develop and maintain the claims dispute process, oversee provider enablement activities specific to the PDP program. 

Primary duties may include, but are not limited to: 
  • Interface with State Medicaid Agency, working in partnership with health plan pharmacy director 
  • Responsible for all PDP program content, assuring this program is implemented and maintained for Healthy Blue 
  • Develop and maintain criteria for REVIEW PROCESS to ensure clinically-based, consistent reviews 
    • Adopt or modify health plan criteria to develop a process that will support clinically-based, consistent reviews for EPSDT, new drugs, Not Otherwise Classified HCPCS codes, and off-label indications.
    • Monitor the manual review queue of HCPCSs that cannot be reviewed for payment using system coding, approve or deny for payment.
    • Work with PBM drug information and specialty teams to incorporate any program elements that will drive clinical quality and program efficiencies. 
  • Oversee the MAINTANENCE MEDICAL CLAIMS CODING process
    • Provide requirements (ICD-10 and other technical elements)to medical claims coding areas 
    • Manage Adds/Deletes as well as modifications to existing drug edits (changes in diagnoses, quantity, age, gender)
    • Assure state Medicaid agency updates are made timely within the health plan medical claims system 
  • Oversee the CLAIMS PAYMENT DISPUTE process
    • Perform clinical/payment dispute reviews and develop best practice case-by-case review process, including the incorporation of health plan policies
    • Manage Adds/Deletes as well as modifications to existing drug edits (changes in diagnoses, quantity, age, gender)
    • Participate in drafting or revising any provider letters and/or criteria templates necessary to support the review, notification of payment, or denial of payment
  • Interface with Health Plan providers, working in partnership with Health Plan Provider Relations
  • Develop provider education materials and communicate with network providers on billing best practices in order to prevent provider abrasion and maintain a reasonable volume of appeals  
  • Perform as the Health Plan SME on specialty drugs, pricing agreements, and acquisition practices, communicating these nuances to providers 




  • Requires a registered pharmacist; minimum 2 years of managed care pharmacy or ACO experience including knowledge of current health care and managed care pharmacy practices; or any combination of education and experience, which would  provide an equivalent background.  
  • Current NC state unrestricted license, or ability to obtain a NC unrestricted State license, to practice pharmacy as a RPH required.  
  • Must demonstrate proficiency in project management 
  • Must demonstrate proficiency in clinical/technical communication to business leaders, an ability to communicate messages pertaining to programs and systems using data and other details in a way business leaders can understand  
  • Must demonstrate proficiency as a key participant in program development, where the program seeks to improve clinical outcomes, quality, cost or other measure. 
  • Experience in data analytics is desired, although not mandatory 
  • Experience with or knowledge of Pharmacy Advisory Committees, (Drug Utilization Review) or P & T Committees 
  • Be able to provide comprehensive solutions to an issue keeping in mind both internal and external needs 
  • Microsoft Office Proficiency: Outlook, Excel, Power Point, Word


To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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