Carelon Payment Integrity Commercialization (Client Systems Support)

Elevance Health • Louisville, KY

3d • Hybrid

About The Position

Carelon Payment Integrity Commercialization (Client Systems Support) Location : This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future visa sponsorship. The Carelon Payment Integrity Commercialization (Client Systems Support) is responsible for serving as a liaison between the customer/provider and the technology group.

Requirements

• Requires a BA/BS degree and a minimum of 0 years of experience or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Understanding of the application of applicable systems and knowledge of medical and pharmacy terminology and HIPAA regulations strongly preferred.
• Healthcare industry knowledge and experience preferred.
• Payment integrity experience preferred. E.G. Subrogation, Coordination of benefits (COB), Data Mining, Fraud, Waste and Abuse etc .
• Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).
• Ability to prioritize competing requests and escalate appropriately.
• Strong research and problem-solving skills; able to find answers across multiple sources and summarize clearly.

Responsibilities

• Assists with the development and implementation of procedures from the customer service aspect for all clients (internal and external).
• Assists in the management of a high-volume shared mailbox by monitoring incoming messages, triaging and prioritizing requests, assigning/forwarding items as needed, and ensuring timely, accurate responses.
• Track inquiries from intake through resolution, perform research to identify answers, and coordinate with internal teams to close out open items.
• Validate client reports for accuracy, completeness, and consistency prior to delivery.
• Track expected vs. received files and promptly identify missing, late, or failed transmissions.
• Review, validate, and implement client exclusion and special handling changes; confirm updates are reflected across all required platforms/tools.
• Assists in the strategy and implementation of new products and services from the production operations perspective.
• Troubleshoots client system questions and processes.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level