Anthem Claims Representative I - II (Hlth & Dntl) - Midland, GA - PS2649 in Midland, Georgia

Claims Representative I/II/III (Health & Dental) - Midland, GA

Our Claims Representative position is an opportunity for you to use your problem solving and research skills to process claims for our consumers (members and providers) in order for them to have a good consumer experience with Anthem.

The Claims Representative has multiple levels; therefore, you can progress your career based on your skills, etc. This role will enable you to set a career path in the healthcare industry and play a vital role in helping Anthem consumers feel connected and educated about their claims benefits.

We are seeking talented, accountable, and enthusiastic individuals to analyze and process claims accurately and timely. A background in the healthcare industry is not required, but you must be a self-motivator and share our commitment to an easy- to-do-business with model.

We are looking for people who have a passion with the following qualities:

  • Treating every claim as if it was your own

  • Taking accountability

  • Helping to resolve problems; desire to “dig deeper”

  • Ability to connect the dots for our consumers (members/providers)

  • Ownership of an issue that may not belong to you

Primary duties may include, but not limited to:

Level I:

Successfully completed the required basic training, able to perform basic job functions with help from co-workers,

specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.

Primary duties may include, but are not limited to:

  • Learning the activities/tasks associated with his/her role.

  • Works under direct supervision.

  • Relies on others for instruction, guidance, and direction.

  • Work is reviewed for technical accuracy and soundness.

  • Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made.

  • Researches and analyzes claims issues.

Level II:

Primary duties may include, but are not limited to:

  • Able to handle more complex claims.

  • Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, gov't regs,

coordination of benefits, & healthcare terminology.

  • Good working knowledge of claims and products, including the grievance and/or re-consideration process.

  • Excellent knowledge of the various operations of the organization, products, and services.

  • Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and


  • Researches and analyzes claims issues.

  • Responds to inquiries, may involve customer/client contact.

  • HS diploma or equivalent.

  • Up to 1 year of related experience; or any combination of education and experience, which would provide an equivalent


  • Good oral and written communication skills.

  • Previous experience using PC, database system, and related software (word processing, spreadsheets, etc.).

  • Ability to work independently as necessary, take ownership and pay attention to detail

  • Analytical and researching skills is preferred.

  • Strong Interpersonal communication skills is preferred.

  • WGS, FACETS, and NETWORX PRICER is preferred.

EOE. M/F/Disability/Veteran.

Job Claims

Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.

Title: Claims Representative I - II (Hlth & Dntl) - Midland, GA - PS2649

Location: GA-Midland

Requisition ID: PS2649