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Anthem, Inc. Business Information Analyst Sr in Des Moines, Iowa

Description

SHIFT: Day Job

SCHEDULE: Full-time

Primary duties may include, but are not limited to:

  • Provides in depth review of claims for overpayment

  • Reviews claims against reimbursement policies, coding guidelines, fee schedules, etc. to ensure payment accuracy

  • Follows claims and reimbursement trends to surface new opportunities

  • Partners with Network and RPM teams to build knowledge base

  • Creates and maintains databases to track business performance.

  • Analyzes data and summarizes performance using summary statistical procedures.

  • Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.

  • Creates and publishes periodic reports, as well as any necessary ad hoc reports.

  • May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

  • May make recommendations based upon data analysis.

  • Provides in depth review of claims for overpayments

  • Reviews claims against reimbursement policies, coding guidelines, fee schedules, etc. to ensure payment accuracy

  • Follows claims and reimbursement trends to surface new opportunities

  • Partners with Network and RPM teams to build knowledge base

Qualifications

  • BS/BA degree in related field

  • 3-5 years data analysis or related experience; or any combination of education and experience, which would provide an equivalent background.

  • Experience with relational databases and knowledge of query tools and statistical software is required.

  • Ability to manipulate large sets of data is also required. .

  • Knowledge of Anthem claim's processing systems preferred

  • Claim and reimbursement knowledge to support opportunity evaluation

  • Medical coding certification a plus

    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. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

    REQNUMBER: PS52621

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