WilmingtonDERecruiter Since 2001
the smart solution for Wilmington jobs

Provider Reimburse Admin

Company: Anthem, Inc
Location: Wilmington
Posted on: March 28, 2020

Job Description:

Provider Reimburse Admin - PS34578Location: Norfolk, Virginia, United StatesNewRequisition #: PS34578Post Date: 16 hours agoYour Talent. Our Vision. At Anthem, Inc. , its a powerful combination, and the foundation upon which were 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.Provider Reimburse Admin In the Office of Norfolk, VA preferred but can be remote within 50 miles from any Anthem office.The Provider Reimburse Admin Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. Must be able to successfully perform all the duties of the Provider Reimburse Admin.Primary duties may include, but are not limited to:Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducts clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy.Translates medical policies into reimbursement rules.Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits.Coordinates research and responds to system inquiries and appeals.Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy.Performs pre-adjudication claims reviews to ensure proper coding was used.Prepares correspondence to providers regarding coding and fee schedule updates.Trains customer service staff on system issues.Works with provider contracting staff when new/modified reimbursement contracts as needed.Requires a BA/BS degree; 2-3 years related experience; or any combination of education and experience, which would provide an equivalent background.CPC Certification Required.At least 2-3 years experience in multi-specialty coding strongly preferred.Proficiency with MS Outlook, Word and Excel strongly preferred.Experience with MS Access a plus.Medical Auditing Experience Preferred.Anthem, Inc. is ranked as one of Americas 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.

Keywords: Anthem, Inc, Wilmington , Provider Reimburse Admin, Administration, Clerical , Wilmington, Delaware

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Administration, Clerical Jobs


Press Secretary
Description: The Climate War Room has an immediate opening for a Press Secretary to execute the team---s earned media strategy and to serve as a spokesperson engaging with state and national reporters. The 2020 presidential (more...)
Company: Center for American Progress
Location: Chevy Chase
Posted on: 04/4/2020

Administrative Support Specialist-(AF ATC)
Description: Overview SUMMARY As a Credence-employed contractor to the Government, you will provide direct support to the U.S. Air Force USAF Medical Support Agency and the Credence Access to Care ATC Team. The (more...)
Company: Credence Management Solutions
Location: Falls Church
Posted on: 04/4/2020

Administrative Assistant II - Gaylord National Resort & Convention Center - (20014781)
Description: Here's To Your Journey with Gaylord Gaylord Hotels is a multi-location hospitality brand guided by a single focus: extraordinary meetings and conventions. From guest rooms and meeting space, to entertainment (more...)
Company: Marriott International, Inc.
Location: Oxon Hill
Posted on: 04/4/2020


Media Internet Customer Service Sales Representative (Home-based)
Description: We are looking for people nationwide interested in working from home that are dependable and looking to make 1,500- 3,000 weekly. You work on your own schedule right from your computer.
Company: Home Job Staffing
Location: Levittown
Posted on: 04/5/2020

Customer Sales/Service - Work Online - $16.00 base-appt.
Description: Customer Sales/Service - Work OnlineVector Marketing is looking to fill remote positions in customer sales and service. We provide flexible schedules for anyone looking to make some extra income around (more...)
Company: Vector Marketing
Location: Warrington
Posted on: 04/5/2020

Receptionist
Description: Essential Job Functions br Responsible for the front desk duties in addition to carrying out general administrative tasks. Presents a friendly and professional atmosphere for all visitors to the community. (more...)
Company: The Landing of Towamencin - Administration
Location: Lansdale
Posted on: 04/5/2020

Exchange and Office 365 Consultant
Description: Management and support of the Exchange environment, a mixture of vendor managed and on-premises. Attending meetings such as Operational, Capacity, etchellip and taking ownership
Company: K-Tek Resourcing LLC
Location: Philadelphia
Posted on: 04/4/2020

Part Time Optometrist in Pleasant Office Setting
Description: Eye Health Physicians of Lancaster has an immediate opening for a part-time optometrist We are a busy yet low key MD/OD private practice
Company: Eye Health Physicians of Lancaster
Location: Lancaster
Posted on: 04/5/2020

ServiceNow Admin
Description: About DMI DMI Digital Management, LLC. , the world's first end-to-end mobility company, combines all the skills and services necessary to deliver mobile enterprise solutions. Built to reinvent business (more...)
Company: DMI
Location: Baltimore
Posted on: 04/5/2020

Executive Administrative Support III - TS/SCI w/ Polygraph Required (Security Clearance Required)
Description: REQ: G2019-66342Public Trust: None Requisition Type: Regular General Dynamics Information Technology is currently seeking a highly skilled Business Administrator Advisor who will be able to perform a (more...)
Company: General Dynamics IT
Location: Mc Lean
Posted on: 04/5/2020

Log In or Create An Account

Get the latest Delaware jobs by following @recnetDE on Twitter!

Wilmington RSS job feeds