Data Entry Specialist (myNEXUS)

Company: Anthem, Inc
Location: Winston Salem
Posted on: June 25, 2022

Job Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At myNEXUS, a proud member of the Anthem, Inc. family of companies, 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.

myNEXUS is a technology-driven, care and benefit management service that enables individuals to live healthier lives in their homes. Our proven clinical model connects individuals to intelligent care delivering independence at lower costs. To maximize health delivery, we consistently leverage our: Innovative Technologies, Advanced Clinical Expertise, and Proprietary Network Engagement Platform. We are continuously pioneering ways to optimize health resources for our clients and their customers. Through our proprietary network management and engagement programs, we realize enhancements in quality, outcomes, and care effectiveness.

Job Summary:

The Data Entry Specialist performs a variety of duties, with the primary focus on data entry. This position requires skill in planning, organizing, and coordinating the delivery of patient care by myNEXUS monitoring services. The position requires strong attention to detail, ability to input information from a document into the myNEXUS system and the ability to self-motivate in a repetitive environment. This person is responsible for data entry of Oasis, determining eligibility for benefits, checking status of authorization, and verification of all information received. The Data Entry Specialist does not conduct any activities that require interpretation of clinical information.

Duties/Responsibilities:

+ Follows all PHI guidelines set forth by myNEXUS to ensure protection of private patient health information.

+ Responsible for managing own work volume and working at a steady and consistent pace.

+ Accurate entry of OASIS data points into NexLync. Ensures all fields are populated correctly in NexLync as provided in the OASIS document.

+ Using discretion and independent judgment in handling patient or physician complaints received, documents and forwards to appropriate administrative staff.

+ Recognizes OASIS document and establishes entry system to ensure OASIS data is entered as efficiently as possible.

+ Escalates abnormal situations to supervisor, making recommendations for resolution.

+ Assists with fax entry and processing of authorizations as needed.

+ Interacts professionally with all, including co-workers and other healthcare providers.

+ Fosters communication among healthcare team on the behalf of the patient.

+ Proficient with myNEXUS systems, operations processes, data entry, and basic computer skills for generation of daily office communication and record generation.

+ Answers incoming calls, if needed to assist patients/clients.

+ Process provider requests in a timely and polite manner.

+ Communicates ideas for improvement to the supervisor.

+ Demonstrate proficiency in meeting and exceeding all required departmental goals and objectives.

+ Reflects knowledge and judgment in decisions and actions within the job description of the Data Entry Coordinator.

+ Must be able to demonstrate team behavior and must be willing to promote a team-oriented environment.

+ Maintains complete and accurate patient care records within company platform.

+ Demonstrates high level customer service skills, both internally and externally.

+ Accepts additional assignments willingly.

+ Supports the Mission and the Core Values of myNEXUS

+ Performs other duties as assigned.

Professional Responsibilities:

+ Completes all compliance related training and demonstrates compliance on the job.

+ Adheres to dress code, appearance is neat and clean.

+ Completes annual education requirements.

+ Maintains patient confidentiality as well as following all PHI guidelines and requirements at all times

+ Reports to work on time and from breaks as scheduled, completes work within designated time.

+ Follows all company policies related to time records and time off policies.

+ Attends annual review and department in-services, as scheduled.

+ Attends at staff meetings and one on one meetings as scheduled and reads all staff meeting minutes and other written documents as requested.

+ Represents the organization in a positive and professional manner.

+ Actively participates in performance improvement and continuous quality improvement (CQI/QA) activities and programs.

+ Complies with all organizational policies regarding ethical business practices.

+ Communicates and demonstrates the mission, ethics and goals of the Company, as well as the department.

Required Skills/Abilities:

+ Shows proficiency with computer programs which may include Microsoft Word, Excel, PowerPoint, Outlook and others.

+ Strong administrative, clerical, and organizational skills.

+ Excellent customer service and follow-up skills.

+ Strong attention to detail and accuracy.

+ Strong Data Entry Skills and ability to work in a repetitive environment.

Education and Experience:

Educational Requirements:

+ High School diploma or the equivalent.

Language Skills:

+ Ability to read and communicate effectively in English.

+ Ability to read, analyze, and interpret insurance and medical documents. Must understand and communicate effectively with providers and insurance representatives.

+ Ability to respond to common inquiries or complaints from providers, patients or family members.

+ Must demonstrate the willingness to work in a team environment and be a team player.

+ Possesses the ability to adjust to constantly changing work flows and processes.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For - , is ranked as one of the 2020 World's Most Admired Companies among health insurers by Fortune magazine, and a 2020 America's Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS49991

Keywords: Anthem, Inc, Winston-Salem , Data Entry Specialist (myNEXUS), Administration, Clerical , Winston Salem, North Carolina