"Alerted.org

Your career starts now. We are looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

**Work Arrangement** ;

; ;·; This is a remote position;

Responsibilities:

+ Research, analyze, and process projects or correspondence for all Lines of Business.;;

+ Analyze complex operational claim overpayment issues and provide technical resolution.;

+ Consistently meets or exceeds production standards for Claims Recovery maintaining 99% financial and procedural accuracy.;

+ Identify and recommend areas where changes to existing processes and procedures result in and/or cost avoidance.;

+ Maintains a current working knowledge of processing rules, contractual guidelines, plan policies, and operational procedures to effectively provide technical expertise.;

+ Respond to and update EXP Service Forms within the required timeframe.;;

+ Follow all internal processes and procedures to ensure the department remains in accordance with departmental and company policy and procedures.;

+ Provides recommendations to correct problems and identify trends to ensure department remains in accordance with departmental and company policy and procedures.

Education/Experience:

+ High School/GED required.

+ 1 to 3 years experience in Facets Claims System preferred.

+ In-depth knowledge of claims payment methodology **is required.**

+ Computer skills: MS Office Applications.;;

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.