Anthem Inc. Medical Jobs

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Anthem, Inc. Subrogation Examiner/Subrogation Examiner Sr in Louisville, Kentucky

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.

Given Anthem’s scale, balance sheet, broad national reach and depth at the local market level, Anthem has established a new business unit called the Diversified Business Group. The Diversified Business Group is a solutions-oriented business unit within the Company that will support Anthem and other external clients in the pursuit of transforming healthcare.

This position is posted as a job family and the selected candidate will be placed into the job level commensurate with their experience

Subrogation Examiner:

Subrogation Examiner is responsible for researching and examining routine health claims that may be related to Third Party Liability, Workers' Compensation and other subrogation/reimbursement recovery cases.

Primary duties may include, but are not limited to:

  • Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party.

  • Responds to inquiries regarding information on injury claims.

  • Utilizes various research methods and vendor systems to gather information.

  • Works with subrogation staff, other departments and outside clients to assist with the recovery process.

  • Prepares written communications.

  • Reviews diagnostic and procedure codes to determine claims relevant to each case.

  • Reviews internal systems/applications for various information needs.

  • Assists with small scale special projects.

    Subrogation Examiner Sr

    Subrogation Examiner Sr is responsible for researching and examining routine and moderately complex health claims that may be related to Third Party Liability, Workers' Compensation and other subrogation/reimbursement recovery cases.

    Primary duties may include, but are not limited to:

  • Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party.

  • Responds to inquiries regarding information on injury claims.

  • May assist with training of new associates.

  • Utilizes various research methods and vendor systems to gather information.

  • Works with subrogation staff, other departments and outside clients regarding the recovery process. Prepares written communications.

  • Reviews diagnostic and procedure codes to determine claims relevant to each case.

  • Reviews internal systems/applications for various information needs.

  • Assists with departmental and interdepartmental special projects.

  • May assist with small dollar case negotiations.

Qualifications

Subrogation Examiner:

  • HS Diploma/GED is required.

  • Requires a minimum of 1 year telephone inquiry experience; or any combination of education and experience, which would provide an equivalent background.

  • BA/BS Degree is preferred.

    Subrogation Examiner Sr:

  • HS Diploma/GED is required.

  • Requires 1 years of experience in Workers' Compensation and/or Third Party Liability recoveries or related field; or any combination of education and/or experience, which would provide an equivalent background.

  • BA/BS Degree is 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. 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.

    REQNUMBER: PS57824

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