Elevance Health · 14 hours ago
Provider Reimburse Admin
Chicago, IL
Contract
Hybrid
Entry, Mid Level
$63K/yr - $94K/yr
2+ years expElevance Health is a health company dedicated to improving lives and communities. The Provider Reimburse Admin will be responsible for accurate translation of provider contracts, medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.
Health CareHealth InsurancePersonal HealthWellness
Responsibilities
Ensures accurate adjudication of claims, by translating provider contracts, medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria
Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducts research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy
Translates provider contracts into reimbursement and operational support rules
Coordinates research and responds to system inquiries
Conducts research of audit systems and system edits to identify claims audit rule inventory for accuracy
Trains staff on system issues and rule creations
Works with provider contracting staff when new/modified reimbursement contracts are needed
Qualification
Required
Requires a BA/BS degree
Minimum of 2 years related experience
Any combination of education and experience which would provide an equivalent background
Preferred
Knowledge of provider networks
Knowledge of the medical management process
Knowledge of internal business processes
Expertise with internal local technology
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
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
Company
Elevance Health
Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.
10001+ employees
H1B Sponsorship
Elevance Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (488)
2024 (604)
2023 (660)
2022 (222)
Funding
Current Stage
Public CompanyTotal Funding
unknown2001-10-30IPO
Leadership Team
Gail K. Boudreaux
President and CEO
Geeta Wilson
Chief Technology Officer (CTO): Digital Health and Service Experience Platforms
Recent News
2026-01-23
2026-01-16
Company data provided by crunchbase