Anthem Inc.

  • Los Angeles, CA, USA
Anthem Inc. Remote * (Cerritos, CA, USA)
Sep 16, 2021
Description SHIFT: Day JobSCHEDULE: Full-timeClaims Representative I Managed Care/Health Plan $1,000 Sign-on BonusLocations: TN, AZ, CA, TX, OH, GA, UT, ID (Remote/Telecommute)The Claims Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists, and managers on non-basic issues. Must pass the appropriate pre-employment test battery. Primary duties may include but are not limited to: • Learning the activities/tasks associated with his/her role. • MUST have Medicare Claims experience. • Works under direct supervision. Relies on others for instruction, guidance, and direction. • Work is reviewed for technical accuracy and soundness. • Codes and processes Medicare claims forms for payment ensuring all information is supplied before eligible payments are made. • Researches and analyzes Medicare claims issues. Qualifications Minimum Requirements:Requires HS diploma or equivalent and...
Anthem Inc. Remote * (Brentwood, TN, USA)
Sep 16, 2021
Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At myNEXUS, a proud member of the Anthem, Inc. family of companies, it's a powerful combination. It's 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.myNEXUS is a technology-driven, care and benefit management service that enables individuals to live healthier lives in their homes. Our proven clinical model connects individuals to intelligent care delivering independence at lower costs. To maximize health delivery, we consistently leverage our: Innovative Technologies, Advanced Clinical Expertise, and Proprietary Network Engagement Platform. We are continuously pioneering ways to optimize health resources for our clients and their customers. Through our proprietary network management and engagement programs, we realize enhancements in quality,...
Anthem Inc. Remote * (Norfolk, VA, USA)
Sep 13, 2021
Description SHIFT: Day JobSCHEDULE: Full-timeYour 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.An Operations Expert is responsible for providing technical direction, guidance and resources to claims, customer service, or membership associates on a day-to-day basis.Primary duties may include, but are not limited to:Serves as a first line resource for operation associates for workflow and technical related processes; provides operational training; assists associates by answering day-to-day technical questions;Encourages a teamwork environment; monitors inventory to ensure workflow remains uninterrupted; handles complex case research and resolution; reviews,Interprets and maintains records of service level, quality, accuracy, and productivity;...
Anthem Inc. Remote * (Chicago, IL, USA)
Sep 04, 2021
Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies, it's apowerful combination, and the foundation upon which we're creating greater access to care for our members, greatervalue for our customers, and greater health for our communities. Join us and together we will drive the future of healthcare. This is an exceptional opportunity to do innovative work that means more to you and those we serve.Nurse Reviewers ( Associate or Level I) are responsible for conducting pre-authorization, out of network andappropriateness of treatment reviews for diagnostic imaging and other services by utilizing appropriate policies, clinicaland department guidelines. They collaborate with healthcare providers to promote the most appropriate, highest qualityand effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits.Whether you are newly licensed RN, or have many years of RN experience, we want to...