[Hiring] Claims Analyst @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.

• 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.
• Xcelys experience highly preferred.

Requirements

• 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.