Anthem, Inc. Benefits Analyst III in Placentia, California
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.
Benefits Analyst III
Location: Indiana-Connecticut-Georgia-Virginia-New York-Colorado-California-Kentucky-Maine- Missouri-New Hampshire-Nevada-Ohio-Wisconsin; within commutable distance.
Responsible for translating complex benefit needs into technical requirements in support of claims adjudication . Reviews and analyzes product data from client sources and product development (such as databases and/or spreadsheets) and determines how to model in Anthem’s product configuration software.
Primary duties may include, but are not limited to:
Understands how product data is utilized by claims, customer facing applications, and other integrated systems
Communicates data model and product changes to modelers, developers, claims, QA, business partners and others as needed in a clear and consistent manner.
Designs and builds new complex non-standard benefit plans, reviews and analyze benefit summaries; and identifies best approach to code/develop benefits to achieve optimum adjudication levels.
Maintains avoidance to negative financial, regulatory, and operational impact.
Researches and responds to complex inquiries and resolves defects based on knowledge and analysis of system functionality.
May consult with and mentoring of less experienced team members.
Represents department in meetings including product development, design and implementation.
Must be able to perform all duties of lower-level positions as directed by management.
Experience with medical insurance and claims details (Place of Service, procedure codes, diagnosis codes, etc)
Experience with Anthem WGS ecosystem a plus
Requires a BA/BS degree in a related field; 3-5 years’ experience in claims processing, previous medical health care, analytical experience, or project management experience; 5 + years of benefit coding experience; or any combination of education and experience that would provide an equivalent background.
Associates in this job working from a California location are eligible for overtime pay based on California employment law.
Applicable to Colorado Applicants Only
Annual Salary Range*: $64,400 - $80,500
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
- The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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. An Equal Opportunity Employer/Disability/Veteran.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.