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Anthem, Inc. Claims Representative III in Boston, Massachusetts

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination. It’s 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.

For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Position: Claims Representative I Location: Woburn, MA or Boston, MA Shift: Monday - Friday 8am - 4:30pm (flexible)

The Claims Representative III is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. The incumbent must be able to successfully perform all the duties of the Claims Representative II and work without significant guidance. Primary duties may include, but are not limited to:

  • Participate in claims workflow projects.

  • Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims.

  • Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication.

  • May have customer/client contact.

  • May assist with training of staff.

Qualifications

  • Education: HS diploma or equivalent

  • Experience: 3 - 5 years of internal claims experience; or any combination of education and experience which would provide an equivalent background

  • Knowledge, Skills, & Abilities:

  • Good oral and written communication skills

  • Previous experience using PC, database system, and related software

AnEqualOpportunityEmployer/Disability/Veteran

REQNUMBER: PS40239

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