Provider Experience Consultant

Company: Anthem, Inc.
Location: Eau Claire
Posted on: April 8, 2021

Job Description:

Welcome to the Anthem Careers site! We have been hard at work to improve our job search and application systems to better serve you. It is now easier to find and apply for relevant jobs as well as stay connected with Anthem. Here are a few of the updates you may notice:

• No more profiles! We no longer require you to create a log in and password to apply for a job and you won't be able to access previously created profiles, but don't worry - we still have your previous application(s) on file and you can still track your status by clicking on the "Track Your Job Application Status" button.
• Job Alerts - If you had previously registered to receive job alerts and wish to continue to receive these notifications, please re-register by clicking the "job alert" button.
• NEW! Didn't find a job that is right for you? Join a Talent Network to stay informed on news and job opportunities with the Anthem Team! It is important that you apply using an email address which is unique to you and not shared with a friend, relative, spouse, or significant other. Our recruiting system uses your email address as your unique identifier. If you apply with a shared email address, your application will overwrite any previous applicant record with the same email address. Additionally, please ensure that you use a valid email address, free from typos, as there are a variety of communications which may be sent to the email address with which you apply Provider Experience Consultant Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and 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 will drive the future of health care.--
  This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company. The Provider Experience Consultant will be responsible for providing quality, accessible and comprehensive service to the company's provider community. Develops and maintains positive provider relationships with provider community via a mixture of email, telephonic and face-to-face outreach, by communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues. Primary duties may include, but are not limited to:--
  --- Serves as a knowledge and resource expert regarding provider issues impacting provider satisfaction; researches and resolves complex provider issues and appeals for prompt resolution.--
  --- Works with internal matrix partners to triage issues and submit work requests.
  --- Assigned to Tier 2 and 3 providers.--
  --- Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.--
  --- Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.--
  --- Conducts routine outreach to support the understanding of managed care policies and procedures.--
  --- Coordinates and conducts provider training including developing and distributing provider relations materials.--
  --- Provides assistance regarding Annual Provider Satisfaction Surveys and required corrective action plan implementation and monitoring, education, and non-routine claim issues.--
  --- Coordinates communications process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.--
  --- Coordinates Provider Manual updates/maintenance.--
  --- Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department.--
  --- Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery.--
  --- Researches issues that may impact future provider negotiations or jeopardize network retention.--
  -- Qualifications Requirements
  --- Requires a Bachelor's degree; 3 years of customer service experience including 2 years of experience as a Network Management Rep; or any combination of education and experience, which would provide an equivalent background.--
  --- Travel may be required. Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
  -- Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem. EEO is the Law Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees. Anthem, Inc. is committed to helping individuals with disabilities participate in the workforce and ensuring equal opportunity to apply and compete for jobs. If you are an individual with a disability and require a reasonable accommodation to complete the application process, please email Human Resources at ability@icareerhelp.com for further assistance. *WARNING : Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Please be advised that Anthem will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission here by selecting the 'Rip-offs and Imposter Scams' option. Anthem requires a completed online application for consideration of employment for any position.

Keywords: Anthem, Inc., South Bend , Provider Experience Consultant, Professions , Eau Claire, Indiana