Provider Payment Appeal Analyst I
6 days ago
Anticipated End Date: 2024-12-19 Position Title: Provider Payment Appeal Analyst I Job Description: Provider Payment Appeal Analyst I is responsible for supporting the Payment Dispute process across all lines of business and is specifically responsible for the resolution of Provider Payment Appeal requests. Must be located within 50 miles of Norfolk, VA, Tampa, FL, Houston, TX, Indianapolis, IN, Mason, OH, Costa Mesa, CA, Palo Alto, CA, Rancho Cordova, CA, Walnut Creek, CA, or Woodland Hills, CA. How you will make an impact: Reviews and analyzes provider requests to investigate the outcome of a Reconsideration. Considers all information when determining whether to uphold or overturn primary decision. Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine root cause and appropriate resolution. Must work with Claims Operations to remediate impacted claims. Minimum Requirements: Requires a HS diploma or GED and a 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. Preferred Skills, Capabilities and Experiences: Experience with data analytics preferred. Ability to research preferred. Bachelor's degree preferred. Salary Range: For candidates working in person or remotely in the below location, the salary range for this specific position is $55,212 to $75,916. Location: California In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). Job Level: Non-Management Non-Exempt Workshift: Job Family: CLM > Provider Support Who We Are: Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work: At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and 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. #J-18808-Ljbffr
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