Anthem Process Expert I - PS4520 in Henderson, Nevada
Process Expert I - PS4520
Location: United States
Field: Business Support
Requisition #: PS4520
Post Date: 5 days ago
Your Talent. Our Vision. At Anthem, Inc., 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 atone of America's leading health benefits companies and a Fortune Top 50 Company.
Process Expert I
Assists in communication template configuration (letters and faxes) and workflowset-up for Pharmacy Prior Authorization.
Primary duties may include, but are not limited to:
Monitors reports/has oversight ofcommunicationIntake.
Reviews adjustment requests submitted to Intake site for accuracy and clarifies requests with the submitter as appropriate.
Receives guidance and mentoring from more experienced process experts.
Researches operations workflow problems and system irregularities; assists with the development and testing of process improvement solutions for new systems, new accounts and other operational improvements; assists with the development and leading of project plans and communicating project status.
Pharmacy and Prior Authorization experience highly preferred, although consideration will be given to people with proven experience in setting up and maintaining complex processes.
Must be able to function in a fast paced environment with ever changing priorities.
Successful candidates must be willing to part of a very hard working dedicated team which will mentor new associates to become successful team members.
Requires a BA/BS degree; 3 years related experience (business analysis, process improvement, project coordination), experience in high-volume managed care operations (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background.