RRT Anthem Analyst

Allied Benefit Systems; Chicago (IL); A distancia; USD 60.000 - 75.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, Dental, Vision Insurance

Life and Disability Insurance

Paid Time Off

Tuition Reimbursement

Employee Assistance Program (EAP)

Technology Stipend

Descripción de la vacante

Allied Benefit Systems is seeking an Anthem Analyst for the Rapid Response Team to manage communications, adjustments, and closing claims across Anthem and BCBS applications. You will handle daily reports, processing, and responding to internal inquiries while supporting remote operations.

Ideal candidates have at least 3 years in medical claims processing, experience with QicLink, and strong Excel/Word skills.

Formación

• Minimum 3 years of medical claims processing experience.
• Experience with the QicLink claims processing system preferred.
• Adjustment experience is required and beneficial.
• Proficient in Excel and Word; able to learn Microsoft Access.
• Strong communication skills via email and orally.

Responsabilidades

• Review daily production and adjustment reports to ensure timely closure of claims.
• Process adjustment claims for Anthem and Blue Cross Blue Shield.
• Send adjustment requests to Anthem and BCBS.
• Assist with inquiries from internal departments about Anthem/BCBS.
• Review exception reports from Anthem and close out claims in BCBS apps.
• Work monthly incentive reports to ensure claims are closed.
• Review outbound reports daily for BCBS.
• Perform other duties as assigned.

Conocimientos

Medical claims processing

Adjustments handling

QicLink system

Excel

Word

Microsoft Access

Educación

High School diploma or equivalent

Herramientas

QicLink

Excel

Word

Microsoft Access

Descripción del empleo

Position Summary

The Rapid Response Team (RRT) Anthem Analyst will be responsible for handling all communications, adjustments, and closing out claims through various applications with our outside vendors, Blue Cross Blue Shield and Anthem.

Essential Functions

• Review daily production reports and adjustment reports from Anthem to ensure claims and adjustments are closed within the designated turnaround time.
• Process all adjustment claims for Anthem and Blue Cross Blue Shield.
• Send adjustment requests to Anthem and Blue Cross Blue Shield.
• Assist with questions from other internal departments for both Anthem and Blue Cross Blue Shield.
• Review exception reports sent by Anthem.
• Close out any claims in the various Blue Cross Blue Shield applications.
• Work incentive reports monthly to ensure claims are closed.
• Review outbound reports daily for Blue Cross Blue Shield.
• Other duties as assigned

EDUCATION

• High School diploma or equivalent required

Experience And Skills

• Minimum of 3 years medical claims processing experience required
• Experience with the QicLink claims processing system preferred
• Adjustment experience is required
• Jointly Administered Arrangements (JAA) experience is preferred; however, it is not required
• Applicant should be proficient in using the Excel and Word programs, have experience with or ability to learn Microsoft Access, and communicate effectively both orally and by email

POSITION COMPETENCIES

• Accountability
• Analytical Thinking
• Collaboration
• Communication
• Customer Focus
• Functional Expertise
• Initiative

PHYSICAL DEMANDS

• This is an office environment requiring extended sitting and computer work

WORK ENVIRONMENT

• Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.