🌎
This job posting isn't available in all website languages
📁
Quality
📅
PS14448 Requisition #
Apply for Job
Recommend to a Friend
Sign Up for Job Alerts

 

Your Talent. Our Vision. At Anthem, Inc., 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.

 

Performance Quality Auditor Lead - Remote within 50 miles of Indianapolis, Midland, Virginia Beach/Norfolk, Denver, Fond Du Lac, Tampa, Mason, Richmond, or South Portland

Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. Primary duties may include, but are not limited to:

  • Functions as subject matter expert for multiple types of audits, ensuring the implementation and execution of audits, monitoring adherence to the prescribed audit methodologies and documentation, and completing analysis and trending of audit results.
  • Interacts regularly with business and vendor partners, presenting contractual and audit program results, reviewing discrepancies and validating implementation of action plans, managing appeals processes, identifying process improvement opportunities, and performing calibration sessions for various audit scenarios.
  • Acts as a leader for the team, providing training and guidance for audit staff, answering questions from the staff around the audit process or multiple system questions that may arise, and filling in with managerial duties as required.
  • Assists with managing audit workload and ensures operating efficiency for the audit process.

Requires:

  • BA/BS degree and 5 years of experience including 3 years of progressively responsible audit experience, leadership experience or any combination of education and experience which would provide an equivalent background
  • Basic understanding of statistics
  • Thorough understanding of different audit methodologies, in-depth knowledge of multiple systems and proven understanding of processing principles, techniques and guidelines
  • Excellent organizational, project management, analytical, leadership, verbal and written communication skills required.
  • 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.


Previous Job Searches

Activity Feed

21967
Job shares through Anthem, Inc.
Someone applied to the Customer Care Representative I - Wallingford, CT - PS14751 position. Less than a minute ago
Someone applied to the Health Program Representative I- Norfolk, VA- PS7097 position. Less than a minute ago
Someone applied to the Customer Care Rep - Louisville - PS14688 position. Less than a minute ago
Someone applied to the Medical Assistant II | Upland, CA | Job ID: PS14695 position. Less than a minute ago

Your Skills.
 Our Opportunities

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.

Find A Career

Skills Translator

Enter your Military Occupation Code (MOC) or military or civilian title into our Military Skills Translator tool to see related openings at Anthem for an improved experience locating careers that maximize your military skills

Use Translator