Anthem Account Service Coordinator - 135042 in Norfolk, Virginia

Account Service Coordinator - 135042

Location: Norfolk, Virginia, United States

Field: Sales

Requisition #: 135042

Post Date: May 16, 2018

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 benefits companies and a Fortune Top 50 Company.

Account Service Coordinator (Medicaid) - 135042

The Account Service Coordinator is responsible for providing advanced customer service representation for accounts. Partners with Medicaid Provider Solutions team to better understand drivers of trend; analyze data and identify opportunities for operational improvement AND to drive Cost of Care savings strategies/initiatives to meet Medicaid Provider Strategy and Value Proposition goals.

Primary duties may include, but are not limited to:

  • Interprets and supports plan benefit design.

  • Resolves complex claims, benefit, and enrollment issues.

  • Conducts routine account calls.

  • Provides strategic planning and account management for State/Medicaid accounts

  • Directs/manages administration of contractual requirements and obligations

  • Interfaces with Operations team/internal partners/subject matter experts to ensure smooth delivery of services in accordance with contractual requirements and obligations

  • Interfaces with Health Plans, States, corporate business partners, providers, and members

  • Makes recommendations for improvements to meet customers’ expectations

  • Develops implementation processes and manages reporting processes to meet member market share/provider need and high levels of account satisfaction

  • Be acclimated to Plan designs, benefits, clinical set up, operational details, as well as processes of the accounts

  • Provides off-site customer service, which may include interpreting plan design, researching/resolving phone and written inquiries, resolving claims, benefit and enrollment issues

  • Performs claims surveillance

  • Manages and delivers claims and billing information, cost/trend detail and strategies to help business with provider network concierge operations and cost of care (CoC) management

  • Provides claims and benefit expertise and leadership for new provider Concierge program launches, and provider value proposition program activities

  • Partners with Anthem Provider Solutions teams to better understand drivers of trend; analyze data and identify opportunities for operational improvement AND to drive Cost of Care savings strategies/initiatives to meet Medicaid Provider Solutions organizational goals

  • Requires a BA/BS; 3 years of related experience; or any combination of education and experience, which would provide an equivalent background

  • Account management experience preferred

  • Some travel required

  • Medicaid knowledge/experience required

  • Provider service experience highly preferred

  • 1-3 years of experience managing data/data reporting

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.