Anthem

Anthem.

  • South Bend, IN


  • Long-term.

  • Full-time.

Description SHIFT: Day Task

SCHEDULE: Full-time

Description – External

Your Skill. Our Vision. At Anthem, Inc., it’s an effective mix, and the structure upon which we’re developing higher access to take care of our members, higher worth for our clients, and higher health for our neighborhoods. Join us and together we will drive the future of healthcare.

This is an extraordinary chance to do ingenious work that implies more to you and those we serve at one of America’s leading healthcare business and a Fortune Top 50 Business.

Area: This is a work from house chance. Prospects will be thought about from the following locations, and need to live within 50 miles of an Anthem center.

  • Indiana
  • Georgia
  • Virginia

The Supplier( Coding) Repay Admin guarantees precise adjudication of claims, by equating medical policies, repayment policies, and scientific modifying policies into reliable and precise repayment requirements.

Main tasks might consist of, however are not restricted to:

  • Evaluations business particular, CMS particular, and rival particular medical policies, compensation policies, and modifying guidelines, in addition to performs scientific research study, information analysis, and recognition of legal requireds to support draft advancement and/or modification of business repayment policy.
  • Equates medical policies into repayment guidelines. Carries out CPT/HCPCS code and cost schedule updates, evaluating each brand-new code for protection, policy, compensation advancement, and ramifications for system modifies.
  • Collaborates research study and reacts to system queries and appeals.
  • Carries out research study of claims systems and system modifies to recognize adjudication problems and to examine claims adjudication for precision.
  • Carries out pre-adjudication claims evaluates to make sure appropriate coding was utilized.
  • Prepares correspondence to service providers concerning coding and charge schedule updates.
  • EM Leveling audit experience.
  • Experience operating in a production environment with brief timelines is highly chosen.

Credentials

Certifications – External

Requirements:

  • BA/BS degree; 2-3 years associated experience; or any mix of education and experience, which would offer a comparable background.
  • Time Management abilities is vital.
  • Medicaid Commercial service items knowledge/experience a plus.
  • WGS and ASPECT experience chosen.
  • Needs a present American Academy of Expert Coders (AAPC) CPC or American Health Info Management Association (AHIMA): RHIA, RHIT, CCS, CCS-P coding accreditation.
  • Efficiency in Microsoft Word, Excel and SharePoint chosen.
  • Should have strong research study abilities and carry out well separately and in a group setting.

We provide a series of market-competitive overall benefits that consist of benefit boosts, paid vacations, Paid Time Off, and reward programs (unless covered by a cumulative bargaining contract), medical, oral, vision, brief and long term impairment advantages, 401( k) match, stock purchase strategy, life insurance coverage, health cares and monetary education resources, among others.

Anthem, Inc. is ranked as one of America’s The majority of Appreciated Business amongst health insurance companies by Fortune publication and has actually been called a 2019 Finest Companies for Variety by Forbes. To find out more about our business and use, please visit us at careers.antheminc.com. A Level Playing Field Employer/Disability/Veteran. Anthem promotes the shipment of services in a culturally skilled way and thinks about cultural proficiency when examining candidates for all Anthem positions.

Please be encouraged that Anthem just accepts resumes from companies that have actually a signed contract with Anthem. Appropriately, Anthem is not bound to pay recommendation costs to any company that is not a celebration to an arrangement with Anthem. Hence, any unsolicited resumes, consisting of those sent to employing supervisors, are considered to be the home of Anthem.

Anthem.

  • Apply Now.