Job Description:

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 Apply Now