Provider Payment Appeal Analyst I
Location: Must live within 50 miles of an Elevance Health location.
Work Schedule: Monday - Friday, 7:00 am - 3:30 pm, EST
The Provider Payment Appeal Analyst I supports the Payment Dispute process across all lines of business and is specifically responsible for the resolution of Provider Payment Appeal requests.
How you will make an impact:
- Reviews and analyzes provider requests to investigate the outcome of a Reconsideration.
- Considers all information when determining whether to uphold or overturn primary decision.
- Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine root cause and appropriate resolution.
- Must work with Claims Operations to remediate impacted claims.
Minimum Requirements:
Requires a HS diploma or GED and a minimum of 3 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities & Experiences:
Bachelor's degree preferred
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