Provider Payment Appeals Analyst I
Elevance Health

Job Info

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Title: Provider Payment Appeals Analyst I

Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.

The Provider Payment Appeals Analyst I supports the Payment Dispute process across all lines of business and is specifically responsible for the resolution of Provider Payment Appeal requests.

How you will make an impact:

• Reviews and analyzes provider requests to investigate the outcome of a Reconsideration.
• Considers all information when determining whether to uphold or overturn primary decision.
• Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to determine root cause and appropriate resolution.
• Must work with Claims Operations to remediate impacted claims.

Minimum Requirements

• HS diploma or GED
• Minimum of 3 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• Bachelor's degree preferred.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $25.44/hr. to $38.16/hr.

Locations: California

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.

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