Anthem Network Management Representative II- Eagan, MN or Mendota Heights, MN- PS10230 in Eagan, Minnesota
Network Management Representative II- Eagan, MN or Mendota Heights, MN- PS10230
Location: Eagan, Minnesota, United States
Field: Provider Network Management
Requisition #: PS10230
Post Date: 4 days ago
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 atone of America's leading health benefits companies and a Fortune Top 50 Company.
Network Management Representative II:
Provides comprehensive services to the provider community through researching more complex provider issues.
Primary duties may include, but are not limited to:
Serves as point of contact for other internal departments regarding provider issues that may impact provider satisfaction.
Researches and resolves the more complex provider issues and appeals for prompt resolution.
Coordinates prompt claims resolution through direct contact with providers and claims department.
Provides assistance with policy interpretation.
Researches, analyzes and recommends resolution of provider disputes, issues with billing, and other practices.
Assists providers with provider demographic changes as appropriate.
Responds to provider issues related to billing, pricing, policy, systems and reimbursements.
Determines if providers were paid according to contracted terms.
High school diploma or equivalent;
3-5 years of customer service experience;
One year experience as a Network Representative; or any combination of education and experience, which would provide an equivalent background.
Familiar with Microsoft office suites preferred.
Experience with high volume outbound calls required.
Multi-lingual ability an asset.
For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com An Equal Opportunity Employer/Disability/Veteran