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Medicaid State Operations Analyst

Location: NC
JobFamily: Claims
Req #: PS59560
Date Posted: Jan 6, 2022

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Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

Responsible for researching, analyzing, documenting and coordinating the resolution of escalated and/or complex claims issues for the Health Plan and requires expert knowledge of all systems, tools and processes.

Primary duties may include, but are not limited to: 

  • Receiving and responding to state or federal regulatory complaints related to claims
  • Managing health plan dispute escalations
  • Quality review of various dispute outcomes
  • Managing complex system issues
  • Managing state updates

Qualifications

Requirements: 

  • BA/BS degree
  • Minimum of 5 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry
  • Or any combination of education and experience which would provide an equivalent background


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.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.