Medicaid State Operations Analyst | Anthem, Inc.

 
 

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.

This is a work from home position.

Primary Duties May Include, But Are Not Limited To

The Medicaid State Operations Analyst role is responsible for researching, analyzing, documenting and coordinating the resolution of escalated and/or complex claims issues for the Health Plan and requires expert knowledge of all systems, tools and processes.

  • Receiving and responding to state or federal regulatory complaints related to claims.
  • Managing health plan dispute escalations.
  • Quality review of various dispute outcomes.
  • Managing complex system issues.
  • Managing state updates.

 
 

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.


Qualifications

  • Requires a BA/BS;
  • 5 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry; or any combination of education and experience, which would provide an equivalent background.

 
 

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