What are the responsibilities and job description for the Provider Payment Appeal Analyst II - (REMOTE - US) position at Anthem?
Location: REMOTE - US The Provider Payment Appeal Analyst II supports the Payment Dispute process across all lines of business and is specifically responsible for the resolution of Provider Payment Appeal requests. Primary duties include, but are not limited to: Reviews and analyzes provider requests to investigate the outcome of a Reconsideration.
Considers all information when determining whether to uphold or overturn primary decision.
Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine root cause and appropriate resolution.
Must work with Claims Operations to remediate impacted claims.
The Analyst II will be responsible to manage Claim Payment Appeal escalations and may serve as a liaison between grievances & appeals and /or medical management, legal, service operations and/or other internal departments as appropriate. Qualifications - External Primary requirements Requires a HS diploma or GED
Minimum of 4 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry;
Any combination of education and experience which would provide an equivalent background. Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
The Provider Payment Appeal Analyst II supports the Payment Dispute process across all lines of business and is specifically responsible for the resolution of Provider Payment Appeal requests. Primary duties include, but are not limited to: Reviews and analyzes provider requests to investigate the outcome of a Reconsideration.
Considers all information when determining whether to uphold or overturn primary decision.
Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine root cause and appropriate resolution.
Must work with Claims Operations to remediate impacted claims.
The Analyst II will be responsible to manage Claim Payment Appeal escalations and may serve as a liaison between grievances & appeals and /or medical management, legal, service operations and/or other internal departments as appropriate. Qualifications - External Primary requirements Requires a HS diploma or GED
Minimum of 4 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry;
Any combination of education and experience which would provide an equivalent background. Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
Primary duties include, but are not limited to: Reviews and analyzes provider requests to investigate the outcome of a Reconsideration.
Considers all information when determining whether to uphold or overturn primary decision.
Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine root cause and appropriate resolution.
Must work with Claims Operations to remediate impacted claims.
The Analyst II will be responsible to manage Claim Payment Appeal escalations and may serve as a liaison between grievances & appeals and /or medical management, legal, service operations and/or other internal departments as appropriate. Qualifications - External Primary requirements Requires a HS diploma or GED
Minimum of 4 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry;
Any combination of education and experience which would provide an equivalent background. Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
Reviews and analyzes provider requests to investigate the outcome of a Reconsideration.
Considers all information when determining whether to uphold or overturn primary decision.
Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine root cause and appropriate resolution.
Must work with Claims Operations to remediate impacted claims.
The Analyst II will be responsible to manage Claim Payment Appeal escalations and may serve as a liaison between grievances & appeals and /or medical management, legal, service operations and/or other internal departments as appropriate. Qualifications - External Primary requirements Requires a HS diploma or GED
Minimum of 4 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry;
Any combination of education and experience which would provide an equivalent background. Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
Qualifications - External Primary requirements Requires a HS diploma or GED
Minimum of 4 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry;
Any combination of education and experience which would provide an equivalent background. Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
Primary requirements Requires a HS diploma or GED
Minimum of 4 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry;
Any combination of education and experience which would provide an equivalent background. Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
Requires a HS diploma or GED
Minimum of 4 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry;
Any combination of education and experience which would provide an equivalent background. Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
Preferred requirements Experience with multiple lines of business a plus.
Bachelor's degree preferred.
Experience with multiple lines of business a plus.
Bachelor's degree preferred.
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