You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

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.

Position Purpose: This role will be responsible to support the PHW Critical Incident team. The primary functions will include provision of administrative and operational support for case tracking, reporting, and intake processes. Respond via telephone to issues from internal and external customers, identify and solve issues, send more complex issues to other support function within Claims Support, and follow issues through to completion.

• Respond to telephone inquiries and initiate steps to assist callers
• Research claim payment issues to identify root cause and trends to reduce incorrect payments
• Thoroughly document information, activities, and changes in database.
• Develop and maintain positive customer relations with internal and external customers and coordinate with various functions within the company to ensure problems, requests, and questions are resolved timely.
• Receive and place follow up telephone calls / emails to answer internal and external customer questions that are routine in nature.
• Relay complex claims support issues to other functions within the Client Support Services area.

Education/Experience: High school diploma or equivalent. 3+ years of healthcare customer service, medical claims processing, and technical support experience. Knowledge of healthcare and/or managed care. Experience with medical coding and/or AMISYS preferred.

Pay Range: $19.04 - $32.35 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