Network Data Specialist Sr.- Tampa, FL- PS31057 at Anthem, Inc.

Posted in Management 1 day ago.

This job brought to you by eQuest

Type: Full-Time
Location: Tampa, Florida





Job Description:

Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide.

Your Talent. Our Vision. At America’s First Choice, 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.
 
Position:  Network Data Specialist Sr. 
 
Location:  Tampa, FL

Network Data Specialist Sr. 

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. 

Requires a H.S. diploma; 3-5 years Provider Database Rep experience; 
or any combination of education and experience, which 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.