Anthem

Anthem.

  • Steubenville, OH


  • Long-term.

  • Full-time.

Description SHIFT: Day Job

SCHEDULE: Full-time

Description – External

Your Talent. 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 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 suggests more to you and those we serve at one of America’s leading healthcare business and a Fortune Top 50 Company.

Location: 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 Provider( Coding) Reimburse Admin guarantees precise adjudication of claims, by equating medical policies, repayment policies, and medical modifying policies into efficient and precise compensation requirements.

Primary responsibilities might consist of, however are not restricted to:

  • Reviews business particular, CMS particular, and rival particular medical policies, repayment policies, and modifying guidelines, along with carries out medical research study, information analysis, and recognition of legal requireds to support draft advancement and/or modification of business repayment policy.
  • Translates medical policies into compensation guidelines. Carries out CPT/HCPCS code and charge schedule updates, examining each brand-new code for protection, policy, compensation advancement, and ramifications for system modifies.
  • Coordinates research study and reacts to system queries and appeals.
  • Conducts research study of claims systems and system modifies to determine adjudication concerns and to examine claims adjudication for precision.
  • Performs pre-adjudication claims examines to guarantee appropriate 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.

Qualifications

Qualifications – 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 company items knowledge/experience a plus.
  • WGS and FACETS experience chosen.
  • Requires a present American Academy of Professional Coders (AAPC) CPC or American Health Information Management Association (AHIMA): RHIA, RHIT, CCS, CCS-P coding accreditation.
  • Proficiency in Microsoft Word, Excel and SharePoint chosen.
  • Must have strong research study abilities and carry out well separately 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 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 Most Admired Companies amongst health insurance providers by Fortune publication and has actually been called a 2019 Best Employers for Diversity by Forbes. To get more information about our business and use, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the shipment of services in a culturally qualified way and thinks about cultural proficiency when assessing candidates for all Anthem positions.

Please be recommended that Anthem just accepts resumes from companies that have actually a signed contract with Anthem. Appropriately, Anthem is not bound to pay recommendation charges to any company that is not a celebration to a contract with Anthem. Hence, any unsolicited resumes, consisting of those sent to employing supervisors, are considered to be the residential or commercial property of Anthem.

Anthem.

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