Anthem, Inc. Financial Operations Analyst Lead in Indianapolis, Indiana
SHIFT: Day Job
Datamining Operations (DMO) is an operational unit that leads the effort to identify, analyze, validate and avoid medical overpayments. DMO’s goal is to deliver measurable cost savings through expense recovery and cost avoidance.
The Financial Operations Analyst Lead is responsible for analyzing data and providing new processes, system enhancements and technical solutions to complex business issues. Leads and coaches staff. Manages workflow and oversees day-to-day department responsibilities. He or she analyzes submitted concepts for recovery opportunities which are provided by various departments such as Claims, Health Plans, etc.
Primary duties may include, but are not limited to:
Perform data mining utilizing coding, policies, benefits, etc., to identify recovery opportunities.
Research all resource documents and web-sites.
Document findings that support the concept.
Request and or run queries as needed to retrieve data.
Meet with various business partners as needed.
Submit enhancement request for database updates.
Assist in implementation and migration of products.
Provide direction and training to team members.
Identify the root cause of needed recoveries.
Is able to commit to deliverables and maintain timely turnaround times while performing quality reviews and accurate processing of projects.
Requires a BS/BA in accounting or finance; 5+ years experience in a finance/health insurance field capacity; prior experience with relational databases, mainframe and client server report writers; project management experience; or any combination of education and experience, which would provide an equivalent background.
Demonstrated proficiency with Excel, Word, PowerPoint
Healthcare related insurance billing and/or claims processing experience is preferred
5+ years of experience with Medicare/Medicaid claims data analysis, claims processing, provider billing, FWA investigations, cost containment
2+ years of experience with data analysis in support of program integrity initiatives.
Medical coding experience- CPT, HCPCS, ICD-9/10
MBA, PMP, CPC or applicable professional designation
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.