Business Analyst II- WGS (CSBD)/Central FACETS

Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem Blue Cross and Blue Shield, a proud member of the Anthem, Inc. family of companies, 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. This position will allow remote work provided the selected candidate currently lives within 50 miles of an Anthem officeTranslates basic business needs into application software requirements. Primary duties may include, but are not limited to:Assessing overpayment opportunities by reviewing low to high volume claim samples

Accessing provider contracts, company claims policy and coding guidelines to support recovery opportunity

Partnering closely with recovery data analysis to create queries that will identify overpayment identifications for recovery

Interacting with query developers, business owners, and business consultants

Managing and prioritizing work assignments based on business needs

Effectively research leads to identify additional recovery savings opportunities

Identifies and analyzes complex overpayment recovery needs to determine optimal means of meeting those needs

Determines specific business requirements to address complex business needs

Identifies process improvement opportunities that result in increased savings

Serve as a liaison between the data science, recovery adjustments and other business partners

Qualifications Requires a BS/BA degree

3-5 years related business analytics experience, to include WGS (CSBD) claims processing, operations or recovery required

Experience using Central FACETS navigation and claim adjustments preferred

Experience using NASCO navigation and claim adjustments highly preferred

Any combination of education and experience, which would provide an equivalent background

Ability to review, understand and apply Anthem reimbursement logic to claims based on Provider Contractual language and Anthem Reimbursement policy, Claims Lab and other region based polices

Proficient with MS Excel

Prefer strategic thinking and collaboration skills and ability

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.REQNUMBER: PS40550