[Hiring] Claims Analyst @Centene Corporation

Role Description

Ensure timely processing of pending medical claims. Verify and update information on the submitted claims. Review work processes to determine reimbursement eligibility. Ensure payments and/or denials are made in accordance with company protocols and procedures.

• Process first time claims
• Apply policy and provider contract provisions to determine if claim is payable
• Research and determine status of medical related claims
• Maintain records, files, and documentation as appropriate
• Meet and maintain department production and quality standards
• Successfully complete additional progressive claims training programs as required
• Perform other duties as assigned
• Comply with all policies and standards

Qualifications

• High school diploma or equivalent
• 1 year of health insurance industry, claims processing, physician’s office or other office services experience
• Proficiency and experience using computers with Microsoft Office (Word, Excel, etc.)
• Ability to perform basic math functions
• Working knowledge of ICD-9/10, CPT, HCPCs, revenue codes, and medical terminology preferred
• Experience with Medicaid or Medicare claims preferred

Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
• Ability to successfully complete basic claims training programs within 6 months of hire required

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules