Job Details: Medical Review Spec I (Job Family) - 35693SY

Company: Wellpoint – WellPoint, Inc. was formed when WellPoint Health Networks, Inc. and Anthem, Inc. merged in 2004 to become the nation’s leading health benefits company. WellPoint, Inc. is the largest health benefits company in terms of commercial membership in the United States.

Description: Anthem Blue Cross is a proud member of the WellPoint family of companies and is one of California's oldest and largest health insurers.

Anthem Blue Cross is a proud member of the WellPoint family of companies and is one of California's oldest and largest health insurers. At Anthem, we are dedicated to our mission of improving the health of the people we serve through improved health of Californians and improved access to care. We believe the best health care coverage can actually help people stay healthy.

Bring your expertise to our innovative, performance-focused culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

This position is for the Post Service Claims review team. Reviews and analyzes institutional and professional claims and supporting medical documents to determine medical necessity of billed services and benefits payable according to established guidelines. Primary duties include, but are not limited to: Reviews, analyzes and renders determinations on requests from the providers and beneficiaries for reconsideration of previously rendered medical decisions relating to claims issues.

This is an entry level Medical Review position. 2 years of college or the equivalent and a minimum of 4 years health care experience or any combination of education and experience, which would provide an equivalent background. Current unrestricted California RN license is required.

WellPoint is ranked No. 1 among health insurers on Fortune Magazine's annual list of America's Most Admired Companies and has been named as one of the Top 50 Companies for Diversity by DiversityInc Magazine. To learn more about our company please visit us at www.wellpoint.com.

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Posting Date: Aug 25 08