Claims Representative I/II (Health & Dental) - Eagan, MN/Gilbert, MN - PS1469

Anthem, Inc. Gilbert, MN
Claims Representative I/II (Health & Dental) - Eagan, MN/ Gilbert, MN - PS1469

Your Talent. Our Vision. At DeCare Dental, a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

Primary duties may include, but are not limited to:

* Able to handle more complex claims.

* Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, gov't regs, coordination of benefits, & healthcare terminology.

* Good working knowledge of claims and products, including the grievance and/or re-consideration process.

* Excellent knowledge of the various operations of the organization, products, and services.

* Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement.

* Researches and analyzes claims issues.

* Responds to inquiries, may involve customer/client contact.

* May participate in claims workflow projects.

* Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims.

* Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication.

* May have customer/client contact.

* May assist with training of staff.

* Works without significant guidance.

Level I:

* HS diploma or equivalent.

* Up to 1 year of related experience;or any combination of education and experience, which would provide an equivalent background.

* Good oral and written communication skills.

* Previous experience using PC, database system, and related software (word processing, spreadsheets, etc.).

* At least 1 year of medical/dental claims processing experience preferred.

* Microsoft Office experience required.

Level II:

* HS diploma or equivalent.

* 1+ years of related experience;or any combination of education and experience, which would provide an equivalent background.

* Good oral and written communication skills.

* Previous experience using PC, database system, and related software (word processing, spreadsheets, etc.).

* At least 1 year of medical/dental claims processing experience preferred.

* Microsoft Office experience required.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.