Senior Provider Escalations Analyst (Remote)

Elevance Health; Indianapolis (IN); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Elevance Health is seeking a Senior Provider Escalations Analyst to manage provider escalation resolutions across lines of business, with responsibilities spanning claim payment determinations, contract interpretation, and clinical policy communication.

The role supports a hybrid/virtual work model and requires collaboration with internal teams and external providers to achieve timely, accurate resolutions.

Qualifications

• Experience in independent dispute resolution is strongly preferred.
• Must have 8+ years of claims research/issue resolution in healthcare.

Responsibilities

• Remediate provider escalations and analyze claim payment or denial impacts.
• Interpret contracts, benefits, and provider policies to resolve complex issues.
• Coordinate root-cause analysis with internal/external partners; mentor escalation analysts.

Skills

Dispute resolution

Education

High School Diploma or GED

Job description

Elevance Health is seeking a Senior Provider Escalations Analyst to manage provider escalation resolutions across lines of business, with responsibilities spanning claim payment determinations, contract interpretation, and clinical policy communication.

The role supports a hybrid/virtual work model and requires collaboration with internal teams and external providers to achieve timely, accurate resolutions.