Claims Examiner II
Elevance Health

Job Info

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Claims Examiner II

***UNION POSITION***

Location : This is a remote position however the associate will be mapped to the Rancho Cordova, CA office and may need to go into the office as requested by management for meetings or training opportunities.

This position will start at the U-15 rate for the first year.

Wage Range : $22.58 - $33.84/hr (Rancho Cordova, CA location)

This is an entry level position. During the time spent in this position the Claims Examiner will develop claims knowledge in all of the functions of the Claims Examiner Il position. Additionally, the associate will develop knowledge on multiple accounts to become proficient in processing and may be assigned to claims, adjustments, and correspondence as required.

Responsibilities include:

• Reviews and evaluates claims for information on which to base payment.
• Manually calculates benefit determinations (non-payable, categories, savings and payments) re-entering claims using the PAC (Pre-Adjudication Correction) process for original and re-opened claims to be adjusted.
• Contacts customers (i.e. subscribers, providers, brokers, and/or policyholders) during the course of review to clarify and/or gather additional information required to process claims and/or resolve inquiries.
• Assists in development of improved workflow and methods.
• Prepares department reports.

Minimum Requirements:

• Two (2) years' experience as an Anthem Claims Examiner I meeting expectations on quality and quantity or three (3) years medical claims processing/health insurance customer service experience or equivalent education.

Preferred Skills, Capabilities & Experiences:

• Thorough knowledge of medical terminology and claims processing procedures/systems.
• Effective communication and personal computer skills

Location: California (The associate will be mapped to the Rancho Cordova, CA office).

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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