Benefits Analyst III

Anthem, Inc. Coconut Grove , FL 33133

Posted 3 weeks ago

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Simply Healthcare, a proud member of the Anthem, Inc. family of companies, it's a powerful combination and the foundation upon which we're creating greater care for our members, greater value for our customers, and greater health for our communities. We are a Florida licensed health maintenance organization that serves individuals enrolled in Medicaid and/or Medicare programs, 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.

Benefits Analyst III (PS37944)

  • This position sits in our Coconut Grove, FL office location and will not be considered a work at home

Summary:Responsible for identifying complex business needs and translates the needs into application software requirements in support of operations, productions and projects.

Primary duties may include, but are not limited to:

  • Designs and builds new complex non-standard benefit plans, reviews and analyze benefit summaries; and identifies best approach to code/develop benefits to achieve optimum adjudication levels.

  • Maintains avoidance to negative financial, regulatory, and operational impact.

  • Performs testing and quality assurance of new product developed.

  • Research and analysis of RFP proposals, and product projects.

  • Create and maintain issue log on appropriate tool, resolve defects based on knowledge and analysis of system functionality.

  • Researches and responds to complex inquiries from various departments.

  • May consult with and mentoring of less experienced team members.

  • Serves as trainer for standard and highly customized benefit configuration.

  • Represents department in production related meetings including product development, design and implementation.

  • Must be able to perform all duties of lower level positions as directed by management.

Qualifications

Qualifications:

  • Requires a BA/BS degree in a related field; 3-5 years experience in claims processing, previous medical health care, analytical experience, or project management experience; 5 + years of benefit coding experience; or any combination of education and experience that would provide an equivalent background.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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Benefits Analyst III

Anthem, Inc.