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 as a contractor at Anthem (via BC Forward) that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Facilitates contract loading and ensures optimal provider service delivery and database accuracy.

Primary duties may include, but are not limited to:

• Identifies, analyzes, and resolves problems for multiple provider database issues.
• Researches and resolves issues for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
• Interprets update requests and coordinates with internal and external customers to clarify and complete the requests.
• Provides timely research of provider information and creates clear and concise provider database update submissions.
• Responsible for reviewing incoming contracts and working with the provider relations reps, providers and the credentialing department to facilitate new and re-contracting efforts for Institutional, Professional, HMO and Ancillary products.
• Researches pended claims, identifies the problems and corrects either internally or via provider education.
• Reviews professional claims to determine correct reimbursements (pre and post processing) to support network contract agreements.

Requirements:

• Requires a H.S. diploma; 3 years of experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background.
• Experience in Excel.
• Good Phone and follow up skills.
• Experience in contracting and credentialing.
• Knowledge in LTC preferred.

Additional Details:

• Schedule: (Remote) Mon - Friday 8:30am - 5:00pom
• This is a remote position, but candidates must be located in Region 1 or 2 in the panhandle of Florida.
• Some local travel (up to 40%) is required and reimbursement for gas mileage is provided.

An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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