Anthem

Anthem.

  • Toledo, OH


  • 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 look after our members, higher worth for our consumers, 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 should live within 50 miles of an Anthem center.

  • Indiana
  • Georgia
  • Virginia

The Service Provider( Coding) Repay Admin makes sure precise adjudication of claims, by equating medical policies, compensation 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, repayment policies, and modifying guidelines, along with performs medical research study, information analysis, and recognition of legal requireds to support draft advancement and/or modification of business repayment policy.
  • Equates medical policies into compensation guidelines. Carries out CPT/HCPCS code and charge schedule updates, evaluating each brand-new code for protection, policy, repayment advancement, and ramifications for system modifies.
  • Collaborates research study and reacts to system questions 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 guarantee correct coding was utilized.
  • Prepares correspondence to suppliers concerning coding and charge schedule updates.
  • EM Leveling audit experience.
  • Experience operating in a production environment with brief timelines is highly chosen.

Certifications

Credentials – External

Requirements:

  • BA/BS degree; 2-3 years associated experience; or any mix of education and experience, which would supply a comparable background.
  • Time Management abilities is necessary.
  • Medicaid Commercial service items knowledge/experience a plus.
  • WGS and ASPECT experience chosen.
  • Needs an existing 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 individually and in a group setting.

We provide a variety of market-competitive overall benefits that consist of benefit boosts, paid vacations, Paid Time Off, and reward bonus offer programs (unless covered by a cumulative bargaining arrangement), medical, oral, vision, brief and long term special needs 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 providers by Fortune publication and has actually been called a 2019 Finest Companies for Variety by Forbes. To get more information 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 proficient 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 obliged to pay recommendation charges to any company that is not a celebration to a contract with Anthem. Therefore, any unsolicited resumes, consisting of those sent to employing supervisors, are considered to be the residential or commercial property of Anthem.

Anthem.

  • Apply Now.