Anthem Operations Expert - Virginia Beach (130948) in Virginia Beach, Virginia

Anthem, Inc.is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.

Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.

Operations Expert

Responsible for providing technical direction, guidance and resources to claims, customer service, or membership associates on a day-to-day basis. Primary duties may include, but are not limited to:
  • Serves as a first line resource for operation associates for workflow and technical related processes;

  • Provides operational training;

  • Assists associates by answering day-to-day technical questions;

  • Encourages a teamwork environment; monitors inventory to ensure workflow remains uninterrupted;

  • Handles complex case research and resolution; reviews,

  • Interprets and maintains records of service level, quality, accuracy, and productivity;

  • Reviews department policy and procedure manuals for accuracy;

  • Works with training department to ensure procedures and policies are accurate and complete.

    This position is located at 1330 Amerigroup Way Virginia Beach, VA 23464 (no relocation assistance available)

    Schedule is Monday - Friday 8 AM to 5:00 PM

    Training Schedule is Monday - Friday 9 AM to 5:30 PM

    This department does have mandatory over-time ranging from 10 to 15 hours a week based on department needs.

/ 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 please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /

/ Requires /

  • HS diploma or equivalent;

  • 5 years’ experience working in a clinical/healthcare environment

  • 3 years’ experience with an Electronic Medical Records or Medical electronic database

  • 3 years of customer service experience

  • 2 years experience with explanation of benefits

  • Experience with Microsoft office (Excel, Work, PowerPoint, and Outlook)

  • Experience mentoring and/or training peers

  • Experience working with clinical data and creating reports

  • Experience working with PC’s and toggling back and forth between screens

  • Experience working with Medicare and Medicaid

  • Team-oriented, demonstrates a professional and cooperative attitude

  • Exhibits flexibility, can multi-task several priorities to completion, finishes ad hoc projects and requests when needed

  • Strong knowledge of company products, policies, procedures, and processes

  • Ability to work well with all levels of management

  • Act as a leader, mentor and exhibit high regard for teamwork and collaboration

  • Maintain a high level of composure and professionalism at all times; build and foster strong working relationships; open-minded; solicits feedback

  • Act with integrity; demonstrate adaptability and execute consistently against job responsibilities

  • Ability to communicate effectively to all levels of internal and external contacts verbally and in written format

  • Excellent collaboration, organizational, time management, and problem-solving skills with the ability to work accurately and meet deadlines

    / Preferred /

  • AA/AS

  • Experience working in call center

  • Previous leadership experience preferred.

  • Inbound and Out Call Center Experience

  • Medical Terminology

  • Core/Senior/GBD FACETS, MACESS, Compass, WGS, Medisys, Ultera experience preferred.

Job Customer Service

Title: Operations Expert - Virginia Beach (130948)

Location: VA-Virginia Beach

Requisition ID: 130948