Claims Research Specialist
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Montana • Pennsylvania • United States
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Salary
💰 $23 - $40 per hour
About the role
- Act as a liaison between provider relations, provider services, health plan, and corporate for claims inquiries
- Respond to internal and external claims related issues
- Initiate entry or change of provider related database information
- Complete claims related research projects
- Assist with data integrity of provider claims processing system
- Investigate and communicate reimbursement and benefit changes
- Educate provider relations and services regarding policies and procedures
- Assist providers with claims submission and payment accuracy
Requirements
- High school diploma or equivalent
- Bachelor’s degree preferred
- 3+ years of experience in claims payment processing in government programs
- Experience in a managed care environment
- Knowledge of claims billing and processing functions
- Knowledge of Medicaid benefits
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims payment processingclaims billingclaims processingdata integrityprovider database managementreimbursement investigationbenefit changes communication
Soft skills
communicationliaisoneducationproblem-solving
Certifications
high school diplomabachelor's degree