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SCA Quality Auditor I/II- PS5713 in Harrisburg, PA at Anthem, Inc.

Date Posted: 5/9/2018

Job Snapshot

Job Description

Your Talent. Our Vision. At National Government Services (NGS), an independent subsidiary of Anthem, Inc. and one of the largest Medicare contractors in the country, it’s a powerful combination.  It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.
 
This is an exceptional opportunity to do innovative work that means more to you and those we serve. 
 
SCA Quality Auditor I
The SCA Quality Auditor I is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines.
Primary duties may include, but are not limited to:
  • Identifies documents and reports any transaction errors in a timely manner to ensure prompt resolution.
  • Applies expert knowledge in most areas.
  • Able to perform simple functions; works under general direction.
  • Tracks and trends audit results, providing feedback to management.
  • Generates monthly reports of audit findings, supports clients with issued identified, develops reports to assist management with information requested.
  • Produces other ad hoc reports as requested by internal and external clients.
 
SCA Quality Auditor II
The SCA Quality Auditor II is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines.
Primary duties may include, but are not limited to:
  • Identifies documents and reports any transaction errors in a timely manner to ensure prompt resolution.
  • Applies expert knowledge in all key areas.
  • Able to perform multiple functions; works under minimal direction.
  • Tracks and trends audit results, providing feedback to management.
  • Generates monthly reports of audit findings, supports clients with issued identified, develops reports to assist management with information requested.
  • Produces other ad hoc reports as requested by internal and external clients.


SCA Quality Auditor I
  • Requires H.S. diploma or equivalent; 9 months to 1 year related experience; or any combination of education and experience, which would provide an equivalent background.
 SCA Quality Auditor II
  • Requires High School diploma; 2 to 3 years related experience; or any combination of education and experience, which would provide an equivalent background. A.S. degree preferred.
 Preferred skills
  • A working knowledge of the Medicare program is required
  • Experience processing Provider enrollment applications is preferred
  • Medicare and Medicaid processing experience; claims, appeals, etc.
  • PECOS, FISS, and/or MCS platform experience/ working knowledge
  • Auditing of operational transactions experience
  • Intermediate to advanced MS Office experience
  • Navigating through SharePoint experience
  • Strong verbal and written communication skills is required
  • Must be able to work in a fast paced/ high volume environment
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.







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