Job details
Job type contract
Full job description
Your talentOur visionAt 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 communitiesJoin us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work as a contractor at anthem (via bc forward) that means more to you and those we serve at one of america`s leading health benefits companies and a fortune top 50 company.
Responsible for keying, processing and/or adjusting health claims in accordance with claims policies and proceduresWorks without significant guidance w/ basic understanding of multiple products (hmo, ppo, cob, etc.)Must be able to successfully perform all the duties of the claims rep i.
Primary duties may include, but are not limited to:
Able to handle more complex claims.
Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, gov`t regs, coordination of benefits, & healthcare terminology.
Good working knowledge of claims and products, including the grievance and/or re-consideration process.
Excellent knowledge of the various operations of the organization, products, and services.
Reviews, analyzes and processes claims/policies related to events to determine extent of company`s liability and entitlement.
Researches and analyzes claims issues.
Responds to inquiries, may involve customer/client contact.
Requires a hs diploma or equivalent; 1-3 years of claims processing experience; previous experience using pc, database system, and related software (word processing, spreadsheets, etc.); or any combination of education and experience, which would provide an equivalent background.
Requirements:
Requires a hs diploma or equivalent; 1-3 years of claims processing experience; previous experience using pc, database system, and related software (word processing, spreadsheets, etc.); or any combination of education and experience, which would provide an equivalent background.
Candidate must have medical claims processing experience.
Should be able to remain focused and achieve high production and quality expectations.
Must be an independent worker .
Proficient computer skills.
Able to work independently.
Strong verbal and written communication.
Knowledge of professional and institutional claim form .
Good time management skills to achieve production expectations.
Excellent quality results to successfully meet accuracy metrics.
Able to handle more complex claims.
Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, gov`t regs, coordination of benefits, & healthcare terminology.
Good working knowledge of claims and products, including the grievance and/or re-consideration process.
Excellent knowledge of the various operations of the organization, products, and services.
Reviews, analyzes and processes claims/policies related to events to determine extent of company`s liability and entitlement.
Researches and analyzes claims issues.
Responds to inquiries, may involve customer/client contact.
Must have strong analytical skills, able to work with little to no supervision and positive attitude.
Additional details:
Standard training hours approx8-4:30 , subject to change with some flexibility after successful training is complete.
Schedule: 8:30am -4:030pm
Prefer candidates that are in miami and within 2 hours of virginia beach but open to candidate near any anthem location (pulse point)
An equal opportunity employerAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
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