Anthem, Inc. Fin Ops Recovery Spec Ld in Norfolk, Virginia
SHIFT: Day Job
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 care companies and a Fortune Top 50 Company.
Provider Experience Consultant
Schedule: Monday-Friday, 8:00 am – 5:00 pm (EST)
Location: Remote now but will be 100% in office TBD Virginia Beach
Duties & Responsibilities
Fin Ops Recovery Spec Ld
• Responsible for the discovery, validation, recovery, and adjustments of claims overpayments.
• May do all or some of the following in relation to cash receipts, cash application, claims audits, collections, overpayment vendor validation, and claims adjustments.
• Primary duties may include, but are not limited to: Audits paid claims for overpayments, using various techniques, including systems-based queries, specialized reporting, or other research.
• Interacts with staff and management from various departments on a regular basis to ensure high quality customer satisfaction.
• May work with external vendors and internal data mining to validate overpayments, validate vendor invoices and provide feedback to modify queries when needed.
• Works closely with management to identify and correct contractual issues, if applicable. Handles complex case research and resolution.
• May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivables processes and all other cash applications.
• Assists in special projects to find and prevent overpayments or to identify process improvements.
• Completes special projects with minimum supervision. Researches voluntary refunds for accuracy.
• Requires accurate balancing of all accounts.
• Trains new associates and provides on-going training to Financial Ops Processors /Recovery Specialists.
• Assists with collecting samples each month from each Recovery Specialists to audit for Quality.
• Distributes work to staff and supports management on a daily basis, including maintaining of inventory reports.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid-19. All offers of employment are conditioned on completion of a background check, including COVID-19 vaccination verification. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
Requires a H.S. diploma and minimum of 4 years claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background. AA/AS or higher level degree preferred.
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.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.