Cost Containment Assoc I or II Denver,CO - (US-CO-Denver - 80299)

Minimum Education: Tech School
Job Type: Full Time
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Anthem Blue Cross and Blue Shield
is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to our mission of improving the health of the people we serve. We believe the best health care coverage can actually help people stay healthy. Bring your expertise to our innovative, performance-focused culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

Cost Containment Associate I or Cost Containment Associate II
Denver, Colorado
The job level will be determined by the skills and experience of the identified applicant.
The Cost Containment Associate I
is responsible for setting up and adjusting claims overpayments that have been previously identified and may do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments and is responsible for more routine issues.
The Cost Containment Associate II
may do all or some of the following and is responsible for the discovery, validation, recovery, and adjustments of claims overpayments; Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other research; Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies; Works closely with contract managers to identify and correct contractual issues when applicable.
Cost Containment Associate I and II
will both have primary duties which may include, but are not limited to:
Reviewing and validating paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.
Determines and calculates amount of overpayments and processes refunds.
Research voluntary refunds for accuracy.
Requires accurate balancing of all accounts.
May interact with internal staff from other departments to ensure customer satisfaction.
Responsibilities may include collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable balances and all other cash applications as required.

Skills:
Cost Containment Associate IRequires a H.S. diploma; 1-2 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background. Associate degree preferred.WGS adjustment experience preferred.Cost Containment Associate IIRequires a H.S. diploma; 2-4 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background. Associate degree or higher level degree preferred.WGS adjustment experience preferred.WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2008 DiversityInc magazine Top 50 Company for Diversity.

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