Provider Payment Appeal Analyst resolving provider payment disputes and coordinating remediation across operations at Elevance Health.
Responsibilities
Support the Payment Dispute process across all lines of business and resolve Provider Payment Appeal requests
Review and analyze provider requests to investigate the outcome of a Reconsideration
Consider all information when determining whether to uphold or overturn primary decision
Work with various departments including Provider Solutions and Health Plan Operations leadership to determine root cause and appropriate resolution
Work with Claims Operations to remediate impacted claims
Virtual role with required in-person training sessions and potential hybrid onsite requirements per company policy
Requirements
HS diploma or GED
Minimum of 3 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry
or any combination of education and experience which would provide an equivalent background
Bachelor's degree preferred
Claims processing experience preferred
WGS/CI&W experience preferred
Must be within a reasonable commuting distance from the posting location(s) unless an accommodation is granted as required by law
Candidates in certain patient/member-facing roles required to become vaccinated against COVID-19 and Influenza (offer rescinded if not vaccinated unless acceptable explanation)
Onboarding Configuration Success Analyst providing technical support for SiteMinder's hotel commerce solutions. Collaborating with teams in a hybrid work setup to assist customers across APAC.
Configuration Success Analyst responsible for managing SiteMinder solutions and assisting customers with technical support. Collaborating with teams to optimize performance and enhance customer satisfaction.
Senior Compensation Analyst analyzing and administering compensation programs for C&W. Collaborating with HR and business teams in compensation analysis and reporting.
Primary System Analyst providing expert level support for Charles River IMS solutions. Involves administration, support, and collaboration with clients and internal teams.
Backend Developer specializing in Java and Spring Framework. Engage in business demands and technical solution implementations in a hybrid work environment based in Barueri/SP.
Administrative Analyst supporting the Afghan Special Immigrant Visa Program at the Department of State. Responsible for data management and mentoring new employees with a focus on accuracy and efficiency.
Contract Analyst II conducting procurement actions for professional services at Florida Department of Transportation. Engaging with stakeholders and leading public meetings in Miami office.
Government Analyst I at Florida Department of Law Enforcement designing and providing training for OROC members. Focus on investigative missions, team building, and change implementation.
Analista Administrativo Sr. responsible for planning and controlling corporate travel for Volkswagen Group Services. Ensuring compliance with internal policies and optimizing costs.