RRT Anthem Analyst
About the position
POSITION SUMMARY: The RRT Anthem Liaison will be responsible for handling all communications, adjustments, and closing out claims through various applications with our outside vendors, Blue Cross Blue Shield and Anthem. ESSENTIAL FUNCTIONS: Review daily production reports and adjustment reports from Anthem to ensure claims and adjustments are closed within the designated turnaround time. Process all adjustment claims for Anthem and Blue Cross Blue Shield. Send adjustment requests to Anthem and Blue Cross Blue Shield. Assist with questions from other internal departments for both Anthem and Blue Cross Blue Shield. Review exception reports sent by Anthem. Close out any claims in the various Blue Cross Blue Shield applications. Work incentive reports monthly to ensure claims are closed. Review outbound reports daily for Blue Cross Blue Shield. Performs other related duties as assigned The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Responsibilities
• Review daily production reports and adjustment reports from Anthem to ensure claims and adjustments are closed within the designated turnaround time.
• Process all adjustment claims for Anthem and Blue Cross Blue Shield.
• Send adjustment requests to Anthem and Blue Cross Blue Shield.
• Assist with questions from other internal departments for both Anthem and Blue Cross Blue Shield.
• Review exception reports sent by Anthem.
• Close out any claims in the various Blue Cross Blue Shield applications.
• Work incentive reports monthly to ensure claims are closed.
• Review outbound reports daily for Blue Cross Blue Shield.
• Performs other related duties as assigned
Requirements
• High School diploma or equivalent required
• Minimum of 3 years medical claims processing experience required.
• Adjustment experience is required.
• Applicant should be proficient in using the Excel and Word programs, have experience with or ability to learn Microsoft Access, and communicate effectively both orally and by email.
Nice-to-haves
• Experience with the QicLink claims processing system preferred.
• Jointly Administered Arrangements (JAA) experience is preferred; however, it is not required.
Benefits
• Medical
• Dental
• Vision
• Life & Disability Insurance
• Generous Paid Time Off
• Tuition Reimbursement
• EAP
• Technology Stipend
Apply Now
Apply Now
POSITION SUMMARY: The RRT Anthem Liaison will be responsible for handling all communications, adjustments, and closing out claims through various applications with our outside vendors, Blue Cross Blue Shield and Anthem. ESSENTIAL FUNCTIONS: Review daily production reports and adjustment reports from Anthem to ensure claims and adjustments are closed within the designated turnaround time. Process all adjustment claims for Anthem and Blue Cross Blue Shield. Send adjustment requests to Anthem and Blue Cross Blue Shield. Assist with questions from other internal departments for both Anthem and Blue Cross Blue Shield. Review exception reports sent by Anthem. Close out any claims in the various Blue Cross Blue Shield applications. Work incentive reports monthly to ensure claims are closed. Review outbound reports daily for Blue Cross Blue Shield. Performs other related duties as assigned The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Responsibilities
• Review daily production reports and adjustment reports from Anthem to ensure claims and adjustments are closed within the designated turnaround time.
• Process all adjustment claims for Anthem and Blue Cross Blue Shield.
• Send adjustment requests to Anthem and Blue Cross Blue Shield.
• Assist with questions from other internal departments for both Anthem and Blue Cross Blue Shield.
• Review exception reports sent by Anthem.
• Close out any claims in the various Blue Cross Blue Shield applications.
• Work incentive reports monthly to ensure claims are closed.
• Review outbound reports daily for Blue Cross Blue Shield.
• Performs other related duties as assigned
Requirements
• High School diploma or equivalent required
• Minimum of 3 years medical claims processing experience required.
• Adjustment experience is required.
• Applicant should be proficient in using the Excel and Word programs, have experience with or ability to learn Microsoft Access, and communicate effectively both orally and by email.
Nice-to-haves
• Experience with the QicLink claims processing system preferred.
• Jointly Administered Arrangements (JAA) experience is preferred; however, it is not required.
Benefits
• Medical
• Dental
• Vision
• Life & Disability Insurance
• Generous Paid Time Off
• Tuition Reimbursement
• EAP
• Technology Stipend
Apply Now
Apply Now