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Anthem, Inc. Network Data Specialist Senior in Montebello, California

Description

SHIFT: Day Job

SCHEDULE: Full-time

Responsible for accurate, timely maintenance of complex provider information and synchronization of data on all claims and provider databases including expertise on business requirements for multiple business regions. Primary duties may include, but are not limited to: Leads the department in problem identification, analysis, and resolution for multiple system provider database issues. Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes. Validates the data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. Researches and resolves complex exceptions and error reports, determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules. Manages prioritizations and escalated issues to resolve provider database errors. Reviews and researches claims issues and provider set up, nonworkable submissions, and question logs to provide production support. Determines training needs and train less experienced associates and outside customers on multiple provider data base systems and business requirements. Audits for functional and business applications, and report accuracy standards.

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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.

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

Requirements:

  • H.S. diploma

  • 3-5 years Provider Database Representative, Claims Pocessing, or Credentialing experience

  • Or any combination of education and experience, which would provide an equivalent background

    REQNUMBER: PS57340

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