[Hiring] Supervisor, Claims @Centene Corporation

Role Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

• Oversee the day-to-day work functions of the assigned claims area.
• Provide technical and leadership support to staff to resolve complex issues.
• Develop and implement policies and procedures that comply with state and federal regulations.
• Process improvement and cost control to process medical claims accurately and timely.
• Serve as a liaison between internal customers, vendors, and other stakeholders involved in the claims life cycle.
• Provide oversight and support to ensure that Claims inventory is managed accurately, timely, and within compliance.
• Prioritize work volumes daily through reporting, load balancing, and managing operational overtime cost.
• Help to identify opportunities for improvements and resolve operational gaps/problems.
• Assist in reviewing, investigating, adjusting, and resolving all pending claims, especially complex claims.
• Serve as a point of escalation for these matters.
• Monitor claims quality reviews for accuracy, document results, and identify trends and systemic root cause analysis.
• Act as the point of contact for the team, the plan, and other departments.
• Responsible for preparing reporting, analysis, and insights consistent with defined standards.
• Maintain appropriate records, files, documentation, etc.
• Special Project work as assigned.
• Facilitate change to support current and future business needs.
• Perform other duties as assigned.
• Comply with all policies and standards.

Qualifications

• Associate degree in related field or equivalent experience required.
• 2+ years of health insurance industry, claims processing, physician’s office, or other office services experience required.
• Previous experience in a supervisory/lead role with defined outcomes required.
• Experience with Medicaid, Marketplace, and/or Medicare preferred.
• Must have successfully completed Centene's additional progressive claims training programs and ramp period.

Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
• Sponsorship and future sponsorship are not available for this opportunity.

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.
• Total compensation may include additional forms of incentives.
• Benefits may be subject to program eligibility.