Claims Analyst

Centene Corporation•Remote-MO, MO

2d•$16 - $27•Remote

About The Position

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. Applicants for this job have the flexibility to work remote from home anywhere in the United States. 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, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Requirements

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.
Ability to successfully complete basic claims training programs within 6 months of hire required.

Nice To Haves

Working knowledge of ICD-9/10, CPT, HCPCs, revenue codes, and medical terminology preferred.
Experience with Medicaid or Medicare claims preferred.

Responsibilities

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.
Performs other duties as assigned.
Complies with all policies and standards.