Claims Analyst

4 days ago

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Centene Corporation

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Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

Contracting • Network Development • Managed Care

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

📋 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 • Ability to successfully complete additional progressive claims training programs within 12 months of hire • 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

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

🏖️ 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