Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.
The position may be located at any of Anthem office location, however preference will be given to the following locations: Woodland Hills, CA, Denver, CO, Norfolk, VA, NYC, NY, Baltimore/Columbia, MD, Mason, OH, Minnetonka, MN, Chicago, IL, Wallingford, CT or Atlanta, GA.
The Program Integrity Analytics Triage Operations Team continuously develops concepts, researches providers and evaluates health care data to determine anomalies and/or aberrancies that require actions in order to ensure that Anthem's resources are utilized in the most efficient and effective ways. This may include prevention of erroneous payment or recovery of erroneously paid dollars. We strive to explain through written and verbal word what the enterprise health care data is telling us. We are a diverse team of professionals with experience in many types of expertise such as clinical, health care coding and billing, investigation, compliance, operations and data analysis.
Typically provides technical assistance to lower level staff. Primary duties may include, but are not limited to: Creates and maintains databases to track business performance. Analyzes health care data and summarizes performance using summary statistical procedures. Creates health care data concepts and develops methods of research and evaluation in determining/identifying patterns of aberrancy. Creates and produces deliverables outlining health care data issues for various actions. May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools. May make recommendations based upon data analysis.
Requires a BS/BA degree in related field; minimum of 3-5 years experience; or any combination of education and experience, which would provide an equivalent background. Experience with relational databases and knowledge of query tools and statistical software is required. Ability to manipulate large sets of data. Strong analytical, organizational, presentation, and problem solving skills. This job is more focused on higher level technical expertise, mentoring staff in lower job levels, more customer facing, higher level of collaboration, work is higher volume and/or higher risk, and modeling as compared to the Bus Info Analyst Sr job.
Strong knowledge of health care data and terminology with the ability to identify provider billing patterns
Strong skills in excel
Strong written and communication skills
Ability to take complex information and make simple, actionable summary
Knowledge of SQL, SAS
Knowledge of systems such as FACETS and EdWard /• /Knowledge of business application of Python, Hadoop and/or Tableau are preferred.
• Certifications associated with health information management and clinical coding
• Experience in health care audits or investigations
• Familiarity with the operations of a health care insurance company
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran./
Job Reporting & Data Analysis
Equal Employment Opportunity Statement
Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.
Title: Business Info Analyst Senior - 134549
Requisition ID: 134549
A little about us:
We have shared values and a similar mission.