Job ID: JP00043292

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) 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?

Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.

Primary duties may include, but are not limited to:

• Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.
• Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.
• Tracks and trends audit results, providing feedback to management.
• Identifies and reports on systemic issues which create ongoing quality concerns.
• Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management with information requested.
• Produces other ad hoc reports as requested by internal and/or external clients.
• Associates at this level conduct routine audits, generally related to a single function on a single systems platform for a single line of business.

Requirements:

• Requires high school diploma or equivalent (GED);
• 2 years experience with the company in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector);
• Working knowledge of insurance industry and medical terminology;
• Working knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines;
• Ability to acquire and perform progressively more complex skills and tasks in a production environment or any combination of education and experience, which would provide an equivalent background.
• Detail-oriented, self-sufficient, self-starter mentality, and proactive learner.
• Ability to succeed in a fast-paced environment.

Additional Details:

• 8:00-5:00 PM EST, 1 Hour Lunch = 40 Hours/Week.
• Work from home// REMOTE.
• Life & disability experience preferred.
• Prior audit experience preferred.
• Previous mentoring, training, or experience developing processes preferred.
• Company encourages constructive feedback and peer mentoring throughout training.

BCForward is An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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