LosAngelesRecruiter Since 2001
the smart solution for Los Angeles jobs

Provider Reimburse Admin

Company: Anthem, Inc
Location: Lawndale
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, Los Angeles , Provider Reimburse Admin, Administration, Clerical , Lawndale, 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


Mover I, Commercial Office Moving
Description: Attention: COVID-19 Update br br In response to the COVID-19 pandemic Corovan is taking measures to assure the continued safety of our employees, prospective employees and the clients we serve. As (more...)
Company: Corovan
Location: Culver City
Posted on: 04/8/2020

Mover I, Commercial Office Moving
Description: Attention: COVID-19 Update br br In response to the COVID-19 pandemic Corovan is taking measures to assure the continued safety of our employees, prospective employees and the clients we serve. As (more...)
Company: Corovan
Location: North Hollywood
Posted on: 04/10/2020

Master Scheduler / Administrative Specialist
Description: Are you ready to put your skills to work on a critical cyber security team in support of an exciting space-focused mission Are you a team player and have willingness to work hard to get the job done (more...)
Company: PARSONS
Location: El Segundo
Posted on: 04/11/2020


Making Money From Your Home Office
Description: We are hiring Benefit Specialist as well as Recruiter/Trainers to fill our team of friendly representatives making a difference
Company: Living Healthy
Location: Anaheim
Posted on: 04/10/2020

Administrative Assistant
Description: We are seeking an Administrative Assistant to join our team You will perform clerical and administrative functions
Company: Alco Air
Location: Los Angeles
Posted on: 04/10/2020

Medical Receptionist Full Time Burbank
Description: Experienced Medical Receptionists Front Office --WantedPosition is for our Burbank Derm officePosition Requirements for our MEDICAL RECEPTIONIST position: li You will work Monday - Friday shifts, usually (more...)
Company: Skin and Beauty Center
Location: Burbank
Posted on: 04/10/2020

Webmethods Admin
Description: Webmethods Admin br br Burbank, CA br br Contract br br JD: br br Experience in software AG WebMethods Intergration Server, Universal
Company: W3Global
Location: Burbank
Posted on: 04/10/2020

WebMethods Admin
Description: CAREER OPPORTUNITY Job Title WebMethods Admin ABOUT CodeForce 360 Making a career choice is amongst the most critical choices one can make, and itrsquos important for the choice to be calculated with (more...)
Company: Codeforce 360
Location: Burbank
Posted on: 04/10/2020

Receptionist
Description: br br br br Receptionist br br br ReceptionistLevel EntryJob Location 999 Corporate in Santa Fe Springs - Santa Fe Springs, CAPosition Type Full TimeEducation Level High SchoolSalary Range (more...)
Company: Windsor Fashions
Location: Santa Fe Springs
Posted on: 04/10/2020

Seeking Health Care Associates to Start a HOME OFFICE POSITION!!
Description: Leading Health Care and Dental Benefits Discount Company is seeking Health Representatives that
Company: Living Healthy
Location: Los Angeles
Posted on: 04/10/2020

Log In or Create An Account

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

Los Angeles RSS job feeds