Anthem, Inc. Claims Rep II (Hlth & Dntl) in Hingham, Massachusetts
SHIFT: Day Job
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.
The Claims Representative II will be responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. Works without significant guidance w/ basic understanding of multiple products (HMO, PPO, COB, etc.). Must be able to successfully perform all the duties of the Claims Rep I.
Primary duties may include, but are not limited to:
Able to handle more complex claims
Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regs, coordination of benefits, & healthcare terminology
Good working knowledge of claims and products, including the grievance and/or re-consideration process
Excellent knowledge of the various operations of the organization, products, and services
Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement
Researches and analyzes claims issues
Responds to inquiries, may involve customer/client contact
Requires a HS diploma or equivalent and a minimum of 1 year of claims processing experience; or any combination of education and experience which would provide an equivalent background
Previous experience using PC, database system, and related software (word processing, spreadsheets, etc.)
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.