Anthem Inc. Indianapolis Jobs

Job Information

Anthem, Inc. Process Expert I- Pharmacy Operations (PS37654) in Indianapolis, Indiana

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At 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 communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

This position will allow remote with any Ingenio Office Based preferred: (Atlanta, GA / Chicago, IL / Las Vegas, NV / Louisville, KY / Mason, OH / Minnetonka, MN / Morristown, NY / St. Louis, MO / Virginia Beach, VA / Wallingford, CT)

This position is to support subrogation claims processing process for Pharmacy Operations.

Primary duties involve -

  • Reviewing intake queue

  • Reviewing documents to enter claim relevant information to process claims

  • Reviewing and processing claims

  • Generating reject letters

  • Determining process improvement opportunities and identifying claims processing efficiency opportunities

  • This candidate will have to interact with subject matter experts and other dependent stakeholders on a daily basis to perform their job duties

  • Maintaining confidentiality of data is required

  • Timely processing and reporting of claims is required

  • Ensure daily processing targets are met

  • Interact with external vendor/government entities to respond to questions about claims results.

  • Data analysis skills

  • Ability to develop SQL queries

  • Claims testing experience

  • Ability to do Claims review and determine claim payments for Plan and member responsibility

  • Awareness of NCPDP reject codes and benefit parameters that drive to the reject codes

  • Automation experience

  • Working with IT leads to support business functional testing for changes/enhancements

Qualifications

  • Requires a BA/BS degree

  • 3 years related experience (business analysis, process improvement, claims operations)

  • Or any combination of education and experience, which would provide an equivalent background

  • Experience in high-volume managed care operations (claims, benefits, eligibility, testing)

  • Pharmacy claims review/processing experience highly preferred

  • Issue management experience (identifying, reporting issues and tracking them to closure)

  • For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

REQNUMBER: PS37654

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