Description

SHIFT: Day Job

SCHEDULE: Full-time

Your 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.

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 care companies and a Fortune Top 50 Company.

Verification OHI Specialist II

Virginia Beach, VA - **remote arrangement due to Covid restrictions** open to other Anthem locations or a work-at-home arrangement but must be within 50 miles of an Anthem office location

Our Verification Specialist II serves as a valued member of the Anthem health care team! This position will be responsible for conducting all aspects of the Verification process. By conducting extensive research and investigation of Other Health Insurance (OHI) information provided for GBD Medicaid members, our specialist ensures the information is applied accurately into appropriate systems for claims coordination and recovery efforts. Top candidates for this position will be confident, organized, enthusiastic, self-motivated individuals that are looking for opportunities with long-term employment and career growth!

Primary duties may include, but are not limited to:

Leverage online resources to validate benefit coverages and effective dates and potentially contact a patient's insurance company to verify coverage levels, effective dates and gaps in coverage if unavailable through online resources.
Maintain knowledge of state or carrier-specific processing rules and collaborate with multiple internal departments to verify OHI leads and analyzes requests in combination with current system data to ensure the record is updated accurately.
Possess excellent customer service and time management skills, with the ability to prioritize a demanding workload while producing a superior quality of work within a specified timeframe.
Comply with OHI Cost Containment departmental internal controls, policies and procedures, Anthem’s Compliance Policy, and Code of Ethics.

Required Competencies:

Team-oriented and demonstrates a professional and cooperative attitude
Exhibits flexibility, can multi-task several priorities to completion, finishes ad hoc projects and requests when needed
Ability to work well with all levels of management
Act with integrity; demonstrate adaptability and execute consistently against job responsibilities
Excellent collaboration, organizational, time management, and problem-solving skills with the ability to work accurately and meet deadlines
Proficient in the latest web technologies and working knowledge of various operating systems

Proficient using Microsoft Office
The ability to approach a problem by using logical, systematic, and sequential tactics
Notices discrepancies and trend using data analysis

This position is located at National Support Center II 1330 Amerigroup Way Virginia Beach, VA 23464 (no relocation assistance available)

Schedule: Monday - Friday 8 AM to 4:30 PM EST

Training Schedule: Monday - Friday 9 AM to 5 PM EST

Mandatory over-time based on department needs

Qualifications

Requires:

High school diploma
2 years of data entry experience;
2 years of experience working in a clinical/healthcare environment
2 years of claims or customer service experience and 1 year of coordination of benefits experience; or any combination of education and experience

Preferred:

AA/AS Degree
Experience working in call center Medical Terminology
Experience with explanation of benefits/payments
Experience working with Medicare and/or Medicaid

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.

Verification OHI Specialist II - Military Veterans

VA

VA