Anthem Business Analyst II - Nationwide (Office Based or Remote) - PS1032 in Virginia Beach, Virginia
Your Talent. Our Vision.At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s the foundation upon which we’re creating greater care for our members, greater value for our customers and greater health for our communities. Join us and together we will*drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve.
Location:Can be located anywhere in the US (office or remote). Preferred Location: The preferred location is at1330 Amerigroup Way Virginia Beach,VA, if you are within 35 miles of the office, you will be required to work in office.
The Cost Containment Unit (CCU) is an operational unit that leads the effort to identify, analyze, validate and avoid medical over payments. Cost Containment’s goal is to deliver measurable cost savings through expense recovery and cost avoidance.
_Primary duties may include, but are not limited to:_ • 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. • Is able to commit to deliverables and maintain timely turnaround times.
_Requires:_ • BS/BA degree • 3-5 years related business analysis or finance experience, or any combination of education and experience, which would provide an equivalent background.
_Preferred Requirements:_ • 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 plus
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Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.
Title: Business Analyst II - Nationwide (Office Based or Remote) - PS1032
Location: virginia-Virginia Beach
Other Locations: VA-Virginia Beach
Requisition ID: PS1032