UplandRecruiter Since 2001
the smart solution for Upland jobs

Provider Reimburse Admin

Company: Anthem, Inc
Location: Upland
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, Upland , Provider Reimburse Admin, Administration, Clerical , Upland, California

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


Administrative Assistant
Description: Join one of the top 20 auto finance companies in the industry and grow with us We offer in-house promotions, great benefits, work-life balance, and job stability. If you're looking to work for a rewarding (more...)
Company: Lobel Financial
Location: Anaheim
Posted on: 03/31/2020

Client Business Executive - Western Region
Description: The Opportunity CO-OP Financial Services is bringing digital transformation to the credit union movement. We're creating innovative technology solutions that help not-for-profit credit unions best serve (more...)
Company: Co-Op Financial Services
Location: Rancho Cucamonga
Posted on: 04/3/2020

Procurement Admin Asst. II
Description: Job DescriptionPerforms a variety of support tasks in the procurement department. Verifies accuracy of invoices and other documents or records including detailing financial business transactions e.g., (more...)
Company: BAE Systems
Location: Chula Vista
Posted on: 03/28/2020


Front Office Supervisor $15.71 - $18.11 - Courtyard San Diego Sorrento Valley - (20022232)
Description: Here's To Your Journey with Courtyard With more than 330 managed locations in more than 20 countries Courtyard by Marriott offers a refreshing environment that helps guests stay connected and balanced. (more...)
Company: Marriott International, Inc.
Location: Chula Vista
Posted on: 03/30/2020

Clerical Assistant
Description: This is a long-term temporary contract, scheduled through the end of the year
Company: Partners Personnel
Location: Perris
Posted on: 03/31/2020

Remote Data Entry
Description: We are CalAmp, the pure-play pioneering leader in the mobile connected economy and broader Internet of Things IoT marketplace. We offer solutions that provide visibility and trace ability of mobile (more...)
Company: CALAMP
Location: Irvine
Posted on: 03/31/2020

Executive Office Administrator
Description: Looking to employ an energetic person for a full-time position in our well-established Tustin Oral Surgery practice. We are noted for our friendly, caring, professional environment. Learning,
Company: The Office of Dr. Jeffrey Lee
Location: Tustin
Posted on: 03/31/2020

Data Entry Specialist/Administrative assistant
Description: We are seeking a Data Entry Specialist/Administrative assistant -to join our team You will be responsible for providing top-notch customer service and driving sales to meet weekly monthly and quarterly (more...)
Company: Amazon
Location: Ontario
Posted on: 03/30/2020

Administrative Assistant - The Westin South Coast Plaza, Costa Mesa - (20027794)
Description: Here's To Your Journey with Westin The Westin South Coast Plaza, Costa Mesa, located at 686 Anton Blvd, Costa Mesa, California, 92626 is currently hiring a Administrative Assistant. Responsibilities include: (more...)
Company: Marriott International, Inc.
Location: Anaheim
Posted on: 03/31/2020

Data Entry Specialist/Administrative assistant
Description: We are seeking a Data Entry Specialist/Administrative assistant -to join our team You will be responsible for providing top-notch customer service and driving sales to meet weekly monthly and quarterly (more...)
Company: Amazon
Location: San Bernardino
Posted on: 03/30/2020

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Upland RSS job feeds