Posted:
9/16/2024, 3:08:00 AM
Location(s):
Burbank, California, United States ⋅ Sacramento, California, United States ⋅ California, United States ⋅ Los Angeles, California, United States
Experience Level(s):
Expert or higher ⋅ Senior
Field(s):
Consulting ⋅ Operations & Logistics
Workplace Type:
Hybrid
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.
Position Purpose: Maintain collaborative relationships with physicians, hospitals, ancillary providers along with health plan and corporate teams. Act as the first line of contact for providers/hospitals on claims projects and other non-routine claim issues. Oversee and leads claim root cause and corrective actions, in conjunction with engagement and support from internal departments, and is responsible to communicate the final resolution to the external and/or internal stakeholders, as needed and/or as required. Assists with policy and procedure interpretation. Researches, analyzes and resolves complex problems with claims development and finalization, focusing on continuous process improvement. Responsible for data and business process analysis (documenting business process, gathering requirements).
Education/Experience: Bachelor's Degree in Health Services, Health Care/Hospital Administration, a related field or any or equivalent work experience required. 2+ years in medical claims review and/or claims appeals required. Experience in AVS and Amisys is highly preferred.
Pay Range: $54,000.00 - $97,100.00 per yearCentene 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. Total compensation may also include additional forms of incentives.
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
Website: https://centene.com/
Headquarter Location: St Louis, Missouri, United States
Employee Count: 10001+
Year Founded: 1984
IPO Status: Public
Industries: Enterprise ⋅ Health Care ⋅ Hospital