Anthem, Inc. Claims Representative I & II (Managed Care/ Health Plan) Remote/Telecommute-$1,000 Sign-On Bonus in Hialeah, Florida
SHIFT: Day Job
Description - External
Location: Cerritos, CA and Surrounding Areas
Hours: Start times range from 7:00am-9:00am PST/End times range from 3:30pm-5:30pm PST
Overtime: May be required during the week and also some weekends.
The Claims Rep II is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. Must be able to successfully perform all the duties of the Claims Rep II. The Claims Representative II primary duties may include, but are not limited to: • Participate in claims workflow projects. • Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims. • Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication. • May have customer/client contact. • Must be able to reach/research a Medicare contract. • Must have several year experience in Facility and Professional Claims. • Must have experience in CMS Legalization. • May assist with training of staff. Works without significant guidance.
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. 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.
Claims Representative II Qualifications:
• Requires a HS diploma. • 3-5 years of the company’s internal claims experience; or any combination of education and experience, which would provide an equivalent background.