Claims Analyst at Centene Corporation

Northampton, Massachusetts, United States -

Full Time

Start Date

Immediate

Expiry Date

06 Mar, 26

Salary

26.73

Posted On

06 Dec, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Processing, Medical Terminology, ICD-9, ICD-10, CPT, HCPCs, Revenue Codes, Microsoft Office, Basic Math Functions, Health Insurance, Medicaid, Medicare

Industry

Hospitals and Health Care

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. *Applicants for this job have the flexibility to work remote from home anywhere in the United States. Position Purpose: 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 Education/Experience: 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. For Claims Business Unit: Ability to successfully complete additional progressive claims training programs within 12 months of hire required. Pay Range: $15.58 - $26.73 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Thanks for your interest in Centene and its subsidiary companies. We’re so glad that you’ve decided to fill out an application and take the next step to find your purpose. Also, we’re here to help support you on your candidate journey. Should you need an accommodation, please email recruiting@centene.com. Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.

Responsibilities

Ensure timely processing of pending medical claims and verify and update information on submitted claims. Review work processes to determine reimbursement eligibility and ensure payments and/or denials are made in accordance with company protocols.