Network Management Representative II - Houston, TX - 120502
Location:
Houston, Texas
Posted:
August 05, 2016
Position Type:
Full Time
Category:
Analyst
Reference:
206438631
/ Your Talent. Our Vision. At Amerigroup ,a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it's a powerful combination. It's the foundation upon which we're creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we willdrive the future of health care. /
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/This is an exceptional opportunity to do innovative work that means more to you and those we serve./

Network Management Representative II

Provides comprehensive services to the provider community through researching more complex provider issues.

Primary duties may include, but are not limited to:

Serves as point of contact for other internal departments regarding provider issues that may impact provider satisfaction.

Researches and resolves the more complex provider issues and appeals for prompt resolution.

Coordinates prompt claims resolution through direct contact with providers and claims department.

Provides assistance with policy interpretation.

Researches, analyzes and recommends resolution of provider disputes, issues with billing, and other practices.

Assists providers with provider demographic changes as appropriate.

Responds to provider issues related to billing, pricing, policy, systems and reimbursements.

Determines if providers were paid according to contracted terms.

Requirements:

H.S. diploma

Three to five years of customer service experience with emphasis on claims

Or any combination of education and experience, which would provide an equivalent background.

One year of experience in nursing home billing.
/ Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2016 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at // antheminc.com/careers // . EOE. M/F/Disability/Veteran. /
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Job Provider Network Management

Title: Network Management Representative II - Houston, TX - 120502

Location: TX-Houston

Other Locations: TX-San Antonio

Requisition ID: 120502
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