Business Analyst II
Company: Anthem, Inc
Location: Whittier
Posted on: May 10, 2022
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Job Description:
Description SHIFT: Day JobSCHEDULE: Full-timeBe part of an
extraordinary team We are looking for leaders at all levels of the
organization who are passionate about making an impact on our
members and the communities we serve. You will thrive in a complex
and collaborative environment where you take action and ownership
to solve problems and lead change. Do you want to be part of a
larger purpose and an evolving, high-performance culture that
empowers you to make an impact? LOCATION - REMOTECLAIMS OVERPAYMENT
BUSINESS ANALYST IIBuild the Possibilities. Make an extraordinary
impact. The Cost Containment Unit (CCU) is an operational unit that
leads the effort to identify, analyze, validate and avoid medical
overpayments. Cost Containment's goal is to deliver measurable cost
savings through expense recovery and cost avoidance. How you will
make an impact: - Perform data mining utilizing CPT, HCPCS, DRG,
ICD-9, ICD-10, etc., to identify recovery opportunities. - Research
all resource documents and web-sites. - Document findings that
support the concept. - Request and/or run queries as needed to
retrieve data. - Meet with various business partners as needed. -
Validate overpayments, complete Approach document and forward
necessary files and documents for CCU Load. - Submit enhancement
request for database updates. - Ensures proper review of the
Forager Pipeline and Analyst reports. - Commit to deliverables and
maintain timely turnaround times.Minimum Requirements: - Requires a
BA/BS and minimum of 3 years related business analysis experience,
or any combination of education and experience, which would provide
an equivalent background. Preferred Skills, Capabilities and
Experiences: - Healthcare business analysis experience - Experience
in using Excel, Facets and MACESS - Medical billing and/or claims
processing experience is preferred - 2+ years of experience with
data analysis, claims processing, provider billing, FWA
investigations, cost containment, Medicare, Medicaid, MMP and/or
MedSupp plans - Medical coding experience - CPT, HCPCS, ICD-9/10
coding - CPC or applicable professional designation a
plusQualifications Minimum Requirements: - Requires a BA/BS and
minimum of 3 years related business analysis experience, or any
combination of education and experience, which would provide an
equivalent background. Preferred Skills, Capabilities and
Experiences: - Healthcare business analysis experience - Experience
in using Excel, Facets and MACESS - Medical billing and/or claims
processing experience is preferred - 2+ years of experience with
data analysis, claims processing, provider billing, FWA
investigations, cost containment, Medicare, Medicaid, MMP and/or
MedSupp plans - Medical coding experience - CPT, HCPCS, ICD-9/10
coding - CPC or applicable professional designation a plusFor URAC
accredited areas, the following professional competencies apply:
Associates in this role are expected to have strong oral, written
and interpersonal communication skills, problem-solving skills,
facilitation skills, and analytical skills. If this job is assigned
to any Government Business Division entity, the applicant and
incumbent fall under a `sensitive position - work designation and
may be subject to additional requirements beyond those associates
outside Government Business Divisions. Requirements include but are
not limited to more stringent and frequent background checks and/or
government clearances, segregation of duties principles, role
specific training, monitoring of daily job functions, and sensitive
data handling instructions. Associates in these jobs must follow
the specific policies, procedures, guidelines, etc. as stated by
the Government Business Division in which they are employed.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.The
health of our associates and communities is a top priority for
Anthem. We require all new candidates to become vaccinated against
COVID-19. If you are not vaccinated, your offer will be rescinded
unless you provide - and Anthem approves - a valid religious or
medical explanation as to why you are not able to get vaccinated
that Anthem is able to reasonably accommodate. Anthem will also
follow all relevant federal, state and local laws.Anthem, Inc. has
been named as a Fortune Great Place To Work in 2021, is ranked as
one of the 2021 World's Most Admired Companies among health
insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on
Diversity and Inclusion. To learn more about our company and apply,
please visit us at careers.antheminc.com. Anthem is an Equal
Employment Opportunity employer and all qualified applicants will
receive consideration for employment without regard to age,
citizenship status, color, creed, disability, ethnicity, genetic
information, gender (including gender identity and gender
expression), marital status, national origin, race, religion, sex,
sexual orientation, veteran status or any other status or condition
protected by applicable federal, state, or local laws. Applicants
who require accommodation to participate in the job application
process may contact ability@icareerhelp.com for assistance.
REQNUMBER: PS72777-California
Keywords: Anthem, Inc, Whittier , Business Analyst II, Professions , Whittier, California
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