Claims Examiner I-Ops
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. This is a remote role, and it is highly preferred that the candidate resides in the state of CA. Candidates that reside in/or around Los Angeles may occasionally report to the local office. Seeking a candidate with a Pharmacy Tech background. The position involves reviewing claims for adjudication, adjustment, billing, coding, compliance, and reimbursement. The role also includes processing and resolving pending medical, hospital, and prescription claims, maintaining appropriate records, and entering manual claims into the claims system. Overtime may be mandatory.
Requirements
- High school diploma or equivalent
- 0-2 years of claim processing or medical billing experience in a managed care environment or physician’s office
- Authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
- Pharmacy Tech background
Nice To Haves
- Reside in the state of CA
- Reside in or around Los Angeles
Responsibilities
- Review claims for adjudication, adjustment, billing, coding, compliance and reimbursement
- Review, process and resolve pending medical, hospital and prescription claims
- Maintain appropriate records, files, documentation, etc.
- Enter manual claims into claims system
- Work mandatory overtime as needed
Benefits
- competitive pay
- health insurance
- 401K
- stock purchase plans
- tuition reimbursement
- paid time off
- holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
