Anthem Network Reimburse Analyst (Job Family) - New York (Albany/NYC/Middletown/Melville) - 129426 in Melville, New York
/ Your Talent. Our Vision. / At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater 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.
Title: Network Reimburse Analyst (Job Family) Hours: Standard Business Hours Location: Albany/NYC/Middletown/Melville
Responsible for the reimbursement methodologies and single case agreement process for non-participating practitioners.
Primary duties may include, but are not limited to:
- Develops databases to maintain provider/ancillary contracting/negotiation documentation.
- Researches, analyzes, develops, and recommends cost effective reimbursement methodologies for out of network member/provider negotiations. Ensures single case agreements properly reflect scope of services being rendered and are constructed in accordance with departmental guidelines and statutory requirements.
- Coordinates projects as needed.
*Please note: This position can be filled at Network Reimburse Specialist or Network Reimburse Analyst level, based on candidate's experience and background.*
- Requires a BA/BS degree in a health related field; 2-3 years managed care experience; experience with physician reimbursement/compensation methodologies, benefit and administrative policies and regulatory requirements; or any combination of education and experience, which would provide an equivalent background.
- Claims processing experience required.
- Provider contract negotiation experience strongly desired.
- EOE.M/F/Disability/Veteran / Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2016 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /
Job Provider Network Management
Title: Network Reimburse Analyst (Job Family) - New York (Albany/NYC/Middletown/Melville) - 129426
Other Locations: NY-Melville, NY-Middletown, NY-New York City
Requisition ID: 129426