Location: Indianapolis, IN
Company: Elevance Health
Service Experience. How you will make an impact: Perform audit reviews and adjudication of high dollar claims for accuracy while maintaining acceptable levels of claims inventory and age. Maintain detailed documentation of claim reviews and develops action plans for internal and external audits as needed.
Provide monthly feedback on claims processing errors, identify and recommend process improvement opportunities, and training. Validate and document savings for monthly reporting. Review load balance claims inventory within region and document assigned claims in workflow on a daily basis. Identify payment system and/or coding issues that includes the medical management system and
create requests for updates/changes to processing system. May adjudicate transplant claims; prompt pay review, including manual EOB and manual check requests to providers.
Supports team as subject matter expert on projects by attending meetings, completing UAT and business check out, documentation, etc. Minimum Requirements: Requires a HS diploma or GED and a minimum of 5 years of claims processing experience which includes a minimum of 2 years of level 3 claims processing with ICD9, CPT coding and high level transaction processing ; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: NASCO, WGS
and Facets experience strongly preferred. Prior experience using Xcel preferred.
CI&W experience preferred. For candidates working in person or remotely in the below locations, the salary range for this specific position is $20.53 to $34.51 Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ 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. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.
Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates.
Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health.
We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, interaction, interactionual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@for assistance. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture.
They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy.
Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19.
If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, interaction, interactionual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@for assistance.
Insurance jobs are positions within the insurance industry, where professionals help individuals and businesses manage risk and protect against financial losses. These roles can range from actuaries who analyze data to predict risks, to underwriters who decide what and whom to insure, to claims adjusters who handle the aftermath of an event. Key features include the need for strong analytical abilities, excellent communication skills, and a deep understanding of financial principles and regulations. Working in insurance often requires a balance of technical knowledge and interpersonal skills, with a focus on customer service and problem-solving.
Insurance jobs encompass a variety of roles within the industry focused on assessing risk, providing financial protection, and supporting clients. These positions can range from actuaries who analyze data to predict risk, to claims adjusters who evaluate and process insurance claims. Insurance agents and brokers are also key, selling policies and advising customers on coverage options. The field is known for its stability, as insurance is a necessary service in both good and bad economic times. Moreover, these jobs often require strong analytical skills, attention to detail, and excellent communication abilities, as professionals navigate complex regulations and provide vital assistance to policyholders.
first step in caring for our patients. We are committed to providing Care for Who You Are and What You Need to balance work and life including flexible scheduling , a supportive family-focused culture and first-class compensation and benefits. Your position perks as a Home Health Registered Nurse (RN) Competitive pay Comprehensive onboarding Health, dental, vision for part & full-time positions Wellness reimbursements for physicals and gym memberships Pre-tax FSA and HSA plans (HSA w/company contributions) Generous Paid Time Off plan that increases with tenure 401(k) with company matching contributions Free Continuing Education Units Tuition reimbursement Company paid life and long-term disability
insurance Company paid parental leave with tenure for birth, adoption, and foster parents Voluntary long-term care, critical illness, and accident insurance Employee Assistance program Local and national award programs Referral bonus program Mileage reimbursement Corporate discount program w/access to 300,000 businesses Company assistance program supporting teammates in times of need How you’ll make an impact as a Home Health Registered Nurse (RN) Support patient recovery and ability to stay at home - enabling them to spend quality time with their loved ones and doing the activities they enjoy Empower patients and families to reach healthcare goals by educating them on disease management Case
manage and provide clinical oversight to interdisciplinary team Home Health Registered Nurse (RN) Requirements RN license in the state you work Two years of experience as a registered nurse, home health experience preferred Current driver’s license Current CPR and BCLS certification Care for Who I Am is Caring for Who We Are.
Together We Are: W elcoming everyone. E mpowering belonging. A llying for inclusivity. R emoving barriers. E ngaging community. WE ARE fostering an inclusive environment where every teammate matters and can be their best selves. WE ARE becoming a reflection of our patients, families, and partners. WE ARE transforming care at home for every community serve.
Estimated salary range $729 / year. Actual salary will vary by geographic location and experience. #LI-MA1 Ascension at Home with Compassus Job ID #2023-32773. Posted job title: registered nurse / rn home health About Ascension at Home with Compassus Ascension at Home Together with Compassus delivers compassionate patient-centered home care services including home health, infusion therapy, palliative care and hospice care. Our brand promise, Care for Who I Am, reflects our unique care delivery model, focusing on the individual needs of every patient we serve.
At Ascension at Home, Together with Compassus, we know that caring for our teammates is the first step in caring for our patients. We are committed to providing care for 'Who You Are' and 'What You Need' to balance work and life including flexible scheduling, a supportive family- focused culture and first-class compensation and benefits. Care for Who I Am is Caring for Who We Are. Together We Are: Welcoming everyone. Empowering belonging. Allying for inclusivity. Removing barriers. Engaging community. WE ARE fostering an inclusive environment where every teammate matters and can be their best selves.
WE ARE becoming a reflection of our patients, families, and partners. WE ARE transforming care at home for every community serve. For more details: jobs-search. org/insurance_indianapolis-c430611/job_i1973414696
and regulatory requirements.
" Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role. " Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims.
Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum Qualifications High school diploma or GED. Six months
of experience processing health and welfare claims. Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes.
Possesses a strong work ethic and team player mentality. Highly developed sense of integrity and commitment to customer satisfaction. Ability to communicate clearly and professionally, both verbally and in writing. Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations. Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages. Must be able to work in environment with shifting priorities and
to handle a wide variety of activities and confidential matters with discretion Computer proficiency including Microsoft Office tools and applications.
Preferred Qualifications Experience working in a third-party administrator. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice. Zenith American Solutions Real People. Real Solutions. National Reach. Local Expertise. We are currently looking for a dedicated, energetic Medical Claims Processor with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.
We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American! We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!
Internals to Apply: If you meet the minimum qualifications and are interested in applying for the above position, please submit an application. All applications must be received by 5:00 pm on the Internal Posting Deadline listed above in order to be considered prior to external applicants. Job Posted by Applicant Pro
