Claims Auditor Sr
Company: Anthem, Inc.
Location: Cerritos
Posted on: April 8, 2021
|
|
Job Description:
Welcome to the Anthem Careers site! We have been hard at work to
improve our job search and application systems to better serve you.
It is now easier to find and apply for relevant jobs as well as
stay connected with Anthem. Here are a few of the updates you may
notice:
Remote: w/potential to work in office post COVID
Days Claims Auditor Sr- Is responsible for pre and post payment and
adjudication audits of high dollar claims across multiple lines of
business, claim types and products including complex specialized
claims within Service Experience. Serves as the subject matter
expert for the unit. Primary duties may include but are not limited
to:--
--- Claims Auditor Sr- Performs audits of and may adjudicate
complex high dollar claims while maintaining acceptable levels of
claims inventory and age.
--- Ensures claim payment accuracy by verifying various aspects of
the claim including eligibility, system coding and pricing,
pre-authorization, and medical necessity.
--- Contact's others to obtain any necessary information. Completes
and maintains detailed documentation of audit which includes
decision methodology, system or processing errors, and monetary
discrepancies which are used for financial reporting and trending
analysis.
--- Provides feedback on claims processing errors; identifies
quality improvement opportunities and initiates complex system
requests related to coding or system issues.--
--- Refers overpayment opportunities to Recovery Team.--
--- Serves as a subject matter expert for Policy and Clinical
Guidelines.--
--- Associates at this level serve as a mentor and resource to
other audit staff.--
--- Must possess strong research and problem-solving skills
-- 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. Qualifications QUALIFICATIONS: --- Requires a high
school diploma or GED; 4+ years related experience in a quality
audit capacity (preferably in healthcare or insurance sector) with
consistent above target performance; working knowledge of insurance
industry and medical terminology.--
--- detailed knowledge of relevant systems and proven understanding
of processing principles, techniques and guidelines; and ability to
acquire and perform progressively more complex skills and tasks in
a production environment or any combination of education and
experience which would provide an equivalent background. BA/BS
degree preferred. Please be advised that Anthem only accepts
resumes from agencies that have a signed agreement with Anthem.
Accordingly, Anthem is not obligated to pay referral fees to any
agency that is not a party to an agreement with Anthem. Thus, any
unsolicited resumes, including those submitted to hiring managers,
are deemed to be the property of Anthem. EEO is the Law Please use
the links below to review statements of protection from
discrimination under Federal law for job applicants and employees.
Anthem, Inc. is committed to helping individuals with disabilities
participate in the workforce and ensuring equal opportunity to
apply and compete for jobs. If you are an individual with a
disability and require a reasonable accommodation to complete the
application process, please email Human Resources at
ability@icareerhelp.com for further assistance. *WARNING : Please
beware of phishing scams that solicit interviews or promote
work-at-home opportunities, some of which may pose as legitimate
companies. Please be advised that Anthem will never ask you for a
credit card, send you a check, or ask you for any type of payment
as part of consideration for employment with our company. If you
feel that you have been the victim of a scam such as this, please
report the incident to the Federal Trade Commission here by
selecting the 'Rip-offs and Imposter Scams' option. Anthem requires
a completed online application for consideration of employment for
any position.
Keywords: Anthem, Inc., Cerritos , Claims Auditor Sr, Accounting, Auditing , Cerritos, California
Click
here to apply!
|
Didn't find what you're looking for? Search again!
Other Accounting, Auditing JobsAccountant Description: Business : Entertainment relatedOffice : Los Angeles CA 91342Position for the Accountant br Duty : br -- Prepares payroll reports by compiling summaries of earnings, taxes, deductions, leave, disability, (more...) Company: Pasona N A, Inc. Location: Los Angeles Posted on: 04/16/2021 Credit - Collections Clerk I Description: Careers That Change Lives As a Credit Collections Clerk I, you will responsible for aspects of Insurance verifications and authorization activities, including customer service with an objective of maximizing (more...) Company: Medtronic Location: Los Angeles Posted on: 04/16/2021 Billing Coordinator Description: Law firm seeks a Billing Coordinator with 1 years of experience in a professional services or law firm environment to assist the Associate Director Billing Services, Billing Coordinators and Partners (more...) Company: Kent Daniels and Associates, Inc. Location: Los Angeles Posted on: 04/16/2021 Chief Financial Officer Description: MUST HAVE FINANCIAL DEGREE ALONG WITH FOOD MANUFACTURING EXPERIENCE and BE LOCATED or WILLING TO RELOCATE to LOS ANGELES.POSITION SUMMARYThe ideal candidate for this position of Chief Financial Officer (more...) Company: Top Quality Recruitment (TQR) Location: Los Angeles Posted on: 04/16/2021 Senior Financial Analyst Description: Technology based retail company located near Marina Del Rey is looking for a Senior Financial Analyst or Finance Manager with strong systems skills. The Senior Financial Analyst or Finance Manager will (more...) Company: Ledgent Finance & Accounting Location: Marina Del Rey Posted on: 04/16/2021 Inventory Cost Accounting Assistant Description: Scale is a tech-driven direct-to-consumer company that builds and deploys next-generation CPG brands in the beauty, health and wellness industries. Through our proprietary eCommerce and digital marketing (more...) Company: Scale Media Location: Los Angeles Posted on: 04/16/2021 Business analyst Description: Ref ID: 00320-0011743429Classification: Business AnalystCompensation: 90000.00 to 110000.00 yearly NetSuite Accounting Project Manager for South Bay Co. Please send resume to Eric HerndonI'm currently (more...) Company: Robert Half Location: El Segundo Posted on: 04/16/2021 Emerging Company Solutions - Audit Senior Associate - Southwest Description: A career within External Audit services, will provide you with the opportunity to provide a range of Assurance services and business advice to a variety of clients from small, fast growing clients to (more...) Company: PwC Location: Signal Hill Posted on: 04/16/2021 Finance Project Coordinator Description: Location: REMOTE br Salary: Open br Description: Our client is currently seeking a Finance Project Coordinator br br ul br Description: br br - Manage multiple teams and project meetings (more...) Company: The Judge Group Inc. Location: Los Angeles Posted on: 04/16/2021 Emerging Company Solutions - Audit Senior Associate - Southwest Description: A career within External Audit services, will provide you with the opportunity to provide a range of Assurance services and business advice to a variety of clients from small, fast growing clients to (more...) Company: PwC Location: Los Angeles Posted on: 04/16/2021 |