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Anthem, Inc. Fin Ops Recovery Spec I/II in West Covina, California

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

$1,000 SIGN ON BONUS!!!!!!

Fin Ops Recovery Spec I is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Fin Ops Recovery Spec II is 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, claim audits collections, overpayment vendor validation, and claim adjustments.Must be able to successfully perform all duties of the Fin Ops Recovery I.

Primary duties may include, but are not limited to:

Fin Ops Recovery Level I -

  • Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.

  • Determines and calculates amount of overpayments and processes refunds.

  • Researches voluntary refunds for accuracy.

  • Requires accurate balancing of all accounts.

  • Responsible for more routine issues.

  • May work with internal staff from other departments to ensure customer satisfaction.

  • May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable balances and all other cash applications.

Fin Ops Recovery Level II -

  • Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other research.

  • Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies.

  • Works closely with staff from other departments on a regular basis to ensure customer satisfaction.

  • Works closely with contract managers to identify and correct contractual issues when applicable.

  • May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable processes and all other cash applications as required.

  • Researches voluntary refunds for accuracy.

  • Requires accurate balancing of all accounts.

Qualifications

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.

Minimum Requirements for Level I -

  • Requires a H.S. diploma

  • Minimum of 1 year of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background. AA/AS preferred.

Minimum Requirements for Level II -

  • Requires a H.S. diploma

  • Minimum of 2 years of 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.

REQNUMBER: PS61721

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