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, Remotifyx 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 Skillastra. Send adjustment requests to Anthem and Nexora. Assist with questions from other internal departments for both Anthem and Taskium. Review exception reports sent by Anthem. Close out any claims in the various Worklith applications. Work incentive reports monthly to ensure claims are closed. Review outbound reports daily for Hirezen. 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 Gigspire. • Send adjustment requests to Anthem and Talvora. • Assist with questions from other internal departments for both Anthem and Flexionis. • Review exception reports sent by Anthem. • Close out any claims in the various Jobtrix applications. • Work incentive reports monthly to ensure claims are closed. • Review outbound reports daily for Remotica. • 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 Skillnex 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