Provider Reimbursement Admin Sr- Behavior Health
Elevance Health•Atlanta, VA
•Hybrid
About The Position
The Provider Reimbursement Admin Sr is responsible for ensuring accurate adjudication of claims, by translating various coding, business and billing rules and standards into effective and accurate reimbursement policies. Serves as subject matter expert regarding reimbursement policies, edits, behavioral health standards, billing, and coding conventions.
Requirements
- Requires a BA/BS degree and a minimum of 4 years related experience; or any combination of education and experience, which would provide an equivalent background.
- EST/CST hours only.
- 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.
- This position is not eligible for employment based sponsorship.
Nice To Haves
- CPC-Certified Professional Coder strongly preferred.
- Behavioral health background strongly preferred.
- Strong written and verbal skills.
- Strong critical thinking and analytical skills.
Responsibilities
- Works with vendors and enterprise teams to develop enterprise reimbursement policies and edits, ensuring policies and edits do not conflict with Federal and state mandates.
- May lead the full range of provider reimbursement activities for a state(s).
- Leads projects related to provider reimbursement initiatives.
- Serves as a mentor to less experienced administrators.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
