Anthem, Inc. Verification OHISpecialist III in Norfolk, Virginia
SHIFT: Day Job
OHI Verification Specialist II/III
Our Verification Specialist II serves as a valued member of the Anthem health care team! This position will be responsible for conducting all aspects of the Verification process. By conducting extensive research and investigation of Other Health Insurance (OHI) information provided for GBD Medicaid members, our specialist ensures the information is applied accurately into appropriate systems for claims coordination and recovery efforts. Top candidates for this position will be confident, organized, enthusiastic, self-motivated individuals that are looking for opportunities with long term employment and career growth!
Primary duties may include, but are not limited to:
Leverage online resources to validate benefit coverages and effective dates and potentially contact a patient's insurance company to verify coverage levels, effective dates and gaps in coverage if unavailable through online resources.
Maintain knowledge of state or carrier specific processing rules and collaborate with multiple internal departments to verify OHI leads and analyzes requests in combination with current system data to ensure record is updated accurately.
Possess excellent customer service and time management skills, with the ability to prioritize a demanding work load while producing a superior quality of work within a specified timeframe.
Comply with OHI Cost Containment departmental internal controls, policies and procedures, Anthem’s Compliance Policy, and Code of Ethics.
Team-oriented, demonstrates a professional and cooperative attitude
Exhibits flexibility, can multi-task several priorities to completion, finishes ad hoc projects and requests when needed
Ability to work well with all levels of management
Act with integrity; demonstrate adaptability and execute consistently against job responsibilities
Excellent collaboration, organizational, time management, and problem-solving skills with the ability to work accurately and meet deadlines
Proficient in the latest web technologies and working knowledge of various operating systems
Proficient using Microsoft Office
The ability to approach a problem by using a logical, systematic, and sequential tactics
Notices discrepancies and trend using data analysis
This position is located at National Support Center II 1330 Amerigroup Way Virginia Beach, VA 23464 (no relocation assistance available)
Training Schedule: Monday - Friday 9 AM to 5 PM EST
Mandatory over-time based on department needs
Verification OHI Specialist II/III
High school diploma
2 years of data entry experience;
2 years of experience working in a clinical/healthcare environment
2 years of claims or customer service experience and 1 year of coordination of benefits experience; or any combination of education and experience
Experience working in call center Medical Terminology
Experience with explanation of benefits/payments
Experience working with Medicare and/or Medicaid
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.