SCA Quality Auditor I
DescriptionSHIFT: Day Job
Be 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?
National Government Services is a proud member of Anthem's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.
The SCA Quality Auditor I is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines.
Schedule: Remote, Monday-Friday, 8a-5p with flexibility
Primary duties may include, but are not limited to:
- Identifies documents and reports any transaction errors in a timely manner to ensure prompt resolution.
- Applies expert knowledge in most areas.
- Able to perform simple functions; works under general direction.
- Examines and evaluates on a prepayment basis the accuracy of transactions processed by reviewing policy, procedure and manual input in accordance with guidelines.
- Tracks and trends audit results, providing feedback to management.
- Generates monthly reports of audit findings, supports clients with issued identified, develops reports to assist management with information requested.
- Produces other ad hoc reports as requested by internal and external clients.
- Requires H.S. diploma or equivalent; 9 months to 1 year related experience; or any combination of education and experience, which would provide an equivalent background.
- Provider Customer Care experience
- FISS experience
- Medicare Part A experience
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 If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to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 [email protected] for assistance.
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.