Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for the daily monitoring, and inventory intake entry of items received through the NextGen Application, as well as the research, analysis and root cause determination on low complexity claims inquiries and provider appeals.

Duties may include, but are not limited to:

• Investigates and facilitates the resolution of claims issues, including incorrectly paid claims, by working with multiple operational areas and health plans and analyzing the systems and processes involved in provider information management, pricing and benefits configuration and/or claims processing.
• Identifies the interdependencies of the resolution of claims errors on other activities within operations.
• Coordinates the efforts of several internal departments to determine appropriate resolution of issues within strict timelines.
• Interacts with submitting partners regularly to manage customer expectations, communicate risks and status updates, and ensure issues are fully resolved.

Education Requirements

Requires BA/BS and 2 years of experience in relevant field, 3 years in Claims; or any combination of education and experience, which would provide an equivalent background

Work Hours

8:00am to 4:30pm EST. Position is remote anywhere in the US, however ET/CT locations are preferred due to schedule.

BCForward is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.