Anthem Provider Reimburse Admin Sr - Facets Configuration - Any Anthem Office or Telecommute - 132467 in Woodland Hills, California

/Your Talent. Our Vision./At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater 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 benefits companies and a Fortune Top 50 Company.

The Provider Reimbursement Administrator, Sr (open to remote work) ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. Serves as subject matter expert regarding reimbursement policies, edits, and coding conventions.

Primary duties may include, but are not limited to: * Works with vendors and enterprise teams to develop enterprise reimbursement policies and edits, ensuring policies and edits do not conflict with Federal and state mandates. * Works with other departments on claims adjudication workflow development and business process improvements. * May lead the full range of provider reimbursement activities for a state(s). * Leads projects related to provider reimbursement initiatives. * Utilizes Access to query and build reports for presentations.


  • BA/BS degree; 4-6 years related experience; or any combination of education and experience, which would provide an equivalent background
  • FACETS experience required
  • Access experience required; the ability to query and build reports
  • Experience presenting data to various audience members at all levels preferred
  • Experience facilitating meetings preferred
    / Anthem 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 please visit us at / / //./ / EOE. M/F/Disability/Veteran. /

Job Provider Network Management

Title: Provider Reimburse Admin Sr - Facets Configuration - Any Anthem Office or Telecommute - 132467

Location: california-Woodland Hills

Requisition ID: 132467