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Claims Analyst
Centene CorporationClaims Analyst ensuring timely processing of medical claims at Centene. Verifying information and determining reimbursement eligibility for health insurance.
About the role
Key responsibilities & impact- 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
Requirements
What you’ll need- 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
- Ability to successfully complete basic claims training programs within 6 months of hire required
Benefits
Comp & perks- 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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
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Hard Skills & Tools
claims processingICD-9ICD-10CPTHCPCsrevenue codesmedical terminologybasic math functionsMicrosoft Officeclaims training
Certifications
high school diplomaclaims training programs