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Process Expert I (PS35873)

Company: Anthem
Location: Minnetonka
Posted on: May 24, 2020

Job Description:

Description SHIFT: Day Job SCHEDULE: Full-time 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. Process Expert I (PS35873) Locations: This is an IN-OFFICE ( not remote) position working from one of these offices: 3030 Peachtree Center Avenue NE,Atlanta, GA 30303 233 S Wacker Dr.,Chicago, IL 60606 3634 Maryland Parkway,Las Vegas, NV 89169 13550 Triton Office Park Blvd.,Louisville, KY 40223 4241 Irwin Simpson Road (Bldg II),Mason, OH 45040 5850 Opus Parkway, Suite 160,Minnetonka, MN 55343 450 Headquarters Plaza, East Tower, 4th Floor,Morristown, NJ 07960 1831 Chestnut St.,St Louis, MO 63103 1330 Amerigroup Way,Virginia Beach, VA 23464 108 Leigus Road,Wallingford, CT 06492 Work Hours: 9am-6pm ET Assists in identifying and researching workflow problems and system irregularities.This position is to support claims processing and claims review functions within the Pharmacy Operations team. Primary duties may include, but are not limited to: Monitors reports/has oversight of Intake Site. Reviews adjustment requests submitted to Intake site for accuracy and clarifies requests with the submitter as appropriate. Receives guidance and mentoring from more experienced process experts. Researches operations workflow problems and system irregularities. Assists with the development and testing of process improvement solutions for new systems, new accounts and other operational improvements. Assists with the development and leading of project plans and communicating project status. Reviewing intake queue. Reviewing documents to enter claim relevant information to process claims. 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 QUALIFICATIONS Requires a BA/BS degree; 3 years related experience (business analysis, process improvement, claims operations); Experience in high-volume managed care operations (claims, customer service, enrollment and billing); Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills; Or, any combination of education and experience, which would provide an equivalent background. Preferred Experience: Pharmacy claims review/processing experience. Issue management experience (identifying, reporting issues and tracking them to closure). Information Technology (IT) experience. 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.

Keywords: Anthem, Minnetonka , Process Expert I (PS35873), Other , Minnetonka, Minnesota

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