POSITION SUMMARY:
The RRT Anthem Liaison will be responsible for handling all communications, adjustments, and closing out claims through various applications with our outside vendors, Blue Cross Blue Shield and Anthem.
ESSENTIAL FUNCTIONS:
- Review daily production reports and adjustment reports from Anthem to ensure claims and adjustments are closed within the designated turnaround time.
- Process all adjustment claims for Anthem and Blue Cross Blue Shield.
- Send adjustment requests to Anthem and Blue Cross Blue Shield.
- Assist with questions from other internal departments for both Anthem and Blue Cross Blue Shield.
- Review exception reports sent by Anthem.
- Close out any claims in the various Blue Cross Blue Shield applications.
- Work incentive reports monthly to ensure claims are closed.
- Review outbound reports daily for Blue Cross Blue Shield.
- Performs other related duties as assigned
EDUCATION:
- High School diploma or equivalent required
EXPERIENCE AND SKILLS:
- Minimum of 3 years medical claims processing experience required.
- Experience with the QicLink claims processing system preferred.
- Adjustment experience is required.
- Jointly Administered Arrangements (JAA) experience is preferred; however, it is not required.
- Applicant should be proficient in using the Excel and Word programs, have experience with or ability to learn Microsoft Access, and communicate effectively both orally and by email.
POSITION COMPETENCIES:
- Time Management
- Accountability
- Communication
- Initiative
- Customer Focus
PHYSICAL DEMANDS:
- This is a standard desk role long periods of sitting and working on a computer are required.
WORK ENVIRONMENT:
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.
