Anthem, Inc. Network Data Specialist Senior in Miami Lakes, Florida
SHIFT: Day Job
Be part of an extraordinary team
We are looking for leaders at all levels of the organization 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?
Build the Possibilities. Make an extraordinary impact.
Location: Anywhere in the state of Florida
This position will be primarily work from home but may require attendence in a local Anthem office occasionally as needed.
How you will make an impact:
Responsible for accurate, timely maintenance of complex provider information and synchronization of data on all claims and provider databases including expertise on business requirements for multiple business regions. Primary duties may include, but are not limited to:
Leads the department in problem identification, analysis, and resolution for multiple system provider database issues.
Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.
Validates the data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
Researches and resolves complex exceptions and error reports, determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
Determines training needs and train less experienced associates and outside customers on multiple provider data base systems and business requirements.
Audits for functional and business applications, and report accuracy standards.
High school diploma or GED equivalent
Minimum of 3 years Provider Database Representative experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Medicaid experience preferred.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem 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. Applicants who require accommodation to participate in the job application process may contact firstname.lastname@example.org for assistance.