Elevance Health Reimbursement Implementation Specialist in Grand Prairie, Texas
Reimbursement Implementation Specialist
Job Family: Digital and Technology
Type: Full time
Date Posted:Aug 02, 2022
Req #: JR9958
North Carolina, North Carolina
New Jersey, New Jersey
New York, New York
Provides accurate and timely maintenance of the most complex provider and reimbursement information.
Primary duties may include, but are not limited to:
Synchronizes data on all claims and provider databases and provides expertise on business requirements for multiple business region.
Identifies, analyzes, and resolves issues for multiple system provider databases. Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.
Validates the data to be housed on provider databases and ensures adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
Researches and resolves the most complex exceptions and error reports.
Determines regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
Determines training needs and provides training to less experienced associates and outside customers on multiple provider data base systems and with multiple business requirements.
- Requires a H.S. diploma and a minimum of 5 years provider database experience; or any combination of education and experience, which would provide an equivalent background.
Proficiency with SQL
Proficiency with Excel
Knowledge of reimbursement structures
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact firstname.lastname@example.org for assistance.
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