RRT Anthem Analyst

RRT Anthem Analyst

The RRT Anthem Analyst 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.
• Other duties as assigned

EDUCATION
• High School Diploma or Equivalent Required

EXPERIENCE & SKILLS
• Minimum of 5 years of claims processing experience, preferably on the QicLink claims processing system.
• Adjustment experience is required.
• Jointly Administered Arrangements (JAA) experience is preferred; however, it is not 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.

POSITION COMPETENCIES
• Job Knowledge
• Time Management
• Accountability
• Communication
• Initiative
• Customer Focus

PHYSICAL DEMANDS
• Standard office duties – sitting, working with a computer, etc.

WORK ENVIRONMENT
• Remote

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