ClearwaterRecruiter Since 2001
the smart solution for Clearwater jobs

Provider Reimburse Admin

Company: Anthem, Inc
Location: Clearwater
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, Clearwater , Provider Reimburse Admin, Administration, Clerical , Clearwater, Florida

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


Administrative Assistant
Description: The Administrative Assistant uses experience and professionalism to support a team of Service Delivery professionals in their daily responsibilities. The position's primary focus is to provide outstanding (more...)
Company: Ryan, LLC
Location: Orlando
Posted on: 04/7/2020

Data Entry
Description: Our organization is Developing quickly and we are searching for Those who are inspired and energetic self starters to join our enterprise. You are going to be a huge part to our achievement as our Customer (more...)
Company: Cormadata
Location: Orlando
Posted on: 04/6/2020

Office associate
Description: Answer Phones, Sell services over the phone, input data correctly and accurately into system.
Company: Mosquito Joe of Tampa Bay
Location: Palm Harbor
Posted on: 04/8/2020


Outpatient Managed Care Office Looking For Internal Medicine Doctors In Tampa Bay FL
Description: We have an opportunity for you to live in one of Floridas most beautiful areas. This is a Patient First quality care oriented practice where you will
Company: Medical On Demand Staffing LLC
Location: Largo
Posted on: 04/5/2020

Admin Assistant - Events - JW Marriott Bonnett Creek - (20003694)
Description: Here's To Your Journey with JW Marriott Marriott International portfolio of brands includes both JW Marriott and Marriott Hotels. Marriott Hotels, Marriott Internationals flagship brand with more than (more...)
Company: Marriott International
Location: Lakeland
Posted on: 04/5/2020

Office Nurse (LPN or RN)
Description: OVERVIEW OF POSITION:The Office Nurse is responsible to the Center Administrator and assists, under the direction of the physician, in the provision of direct patient care in accordance with Company policies (more...)
Company: Optum
Location: Saint Petersburg
Posted on: 04/6/2020

Client Care Specialist (Veterinary Receptionist)
Description: Lake Seminole Animal Hospital is looking for an experienced 1-2 years Client Care Specialist to
Company: Lake Seminole Animal Hospital
Location: Largo
Posted on: 04/7/2020

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: Apopka
Posted on: 04/10/2020

Spa and Fitness Receptionist
Description: Essential Functions: Welcome the guests, register them in the computer system, guide them to the Spa Locker-room Attendant and answer questions about the services, costs, spa retail shop, activities at (more...)
Company: Longboat Key Club
Location: North Port
Posted on: 04/6/2020

Making Money From Your Home Office
Description: Health and Dental Benefits Discount Company is expanding new markets and is seeking Benefits Specialist and Recruiters
Company: Living Healthy
Location: Kissimmee
Posted on: 04/7/2020

Log In or Create An Account

Get the latest Florida jobs by following @recnetFL on Twitter!

Clearwater RSS job feeds