Anthem Business Consultant - US - #122260 in Denison, Texas

/ 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.

TheBusiness Consultantposition part of a new and growing area with Anthem to find savings related to claim overpayments. The Business Consultant serves as the liaison between Vendors, the Validation and Query Development teams in translating complex business needs into recovery query development.

Primary duties may include, but are not limited to:

  • Analyzes existing workflows, processes & procedures, supporting systems and claims data to identify complex overpayment recovery opportunities.
  • Develops Business Requirement Documentation and coordinates testing.
  • Works with Query Developers to ensure requirements will be incorporated into recovery query design and testing.

  • Requires a BS/BA degree, 8 - 10 years of business analysis experience, which should include analysis, project management, working knowledge of mainframe computer, hardware and operating systems; or any combination of education and experience, which would provide an equivalent background.

  • In-depth knowledge of claims system, reimbursement, processing and recovery policies are required.
  • Ability to analyze and design solutions to address complex and varied business needs.
  • Can lead teams of analysts assigned to complex projects.
  • Requires effective written, oral and interpersonal communication skills..
  • Commercial/Medicare/Medicaid claims experience required. / 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 and apply, please visit us at EOE. M/F/Disability/Veteran. /

Job Business Support

Title: Business Consultant - US - #122260

Location: TX-Denison

Requisition ID: 122260