Performance Quality Analyst II

Elevance Health (Anthem); Indianapolis (IN); Hybrid; USD 70,000 - 85,000; Full time

Job summary

Elevance Health in Indianapolis is seeking a Performance Quality Analyst II to support field work and audits across multiple lines of business. This hybrid role involves in-office collaboration 1-2 days per week with flexibility for remote work as needed.

Minimum BS/BA with 3+ years in enrollment, billing, claims, or customer contact in a healthcare/insurance setting; at least 1 year in a quality audit capacity. Strong data analysis and process improvement skills are required.

Qualifications

• Requires at least BS/BA and 3+ years in enrollment and billing, claims or customer contact in an automated environment (healthcare/insurance preferred).
• At least 1 year of related quality audit experience.
• Demonstrates analytical audit skills and ability to advise management on process improvements.

Responsibilities

• Assists higher level auditor/lead on field work and acts as auditor in charge on small audits.
• Participates in pre- and post-implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment & billing transactions, and corrective action plans.
• Audits multiple lines of business, functions, and systems; interprets data and recommends changes.
• Collaborates with the business to provide consultation to management on outdated or incomplete policies and procedures and investigates improvements.
• Mentors peer auditors, provides training, and may manage projects.

Skills

Customer service

Audit experience

Quality assurance

Education

BS/BA

Job description

Anticipated End Date

2026-09-30

Position Title

Performance Quality Analyst II

Job Description

Performance Quality Analyst II

Location

Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

How you will make an impact

• Assists higher level auditor/lead on field work as assigned and acts as auditor in charge on small and less complex audits.
• Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment & billing transactions and the corrective action plan process.
• Demonstrates ability to audit multiple lines of business, multiple functions, and multiple systems.
• Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks.
• Works closely with the business to provide consultation and advice to management related to policy and procedure identified as out of date or incomplete and investigates, develops and recommends process improvements and solutions.
• Functions as a subject matter expert for discrepancy review, questions from team and business partners, and interpretation of guidelines and audit process.
• Acts as a mentor to peer auditors, providing training and managing work and projects as necessary.

Minimum Requirements

Requires a BS/BA; a minimum of 3 years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1 year related experience in a quality audit capacity; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

Customer service call center experience , DMHC experience , LOS/NP experience preferred.

Job Level

Non-Management Exempt

Job Family

QLT > Analysis

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.