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

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Claims
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PS11840 Requisition #
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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.

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As one of America’s largest health benefits companies, we at Anthem have a profound appreciation for service. Our organization proudly supports our nation’s active, reserve and veteran military service members and their spouses.

This is an exciting opportunity to advance your life and career, while still protecting and serving others. Come see for yourself why Anthem is recognized as a Top Employer by GI Jobs and among the “Best of the Best: Top Veteran Friendly Companies” by US Veterans Magazine.

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