Risk Adjustment Specialist – Non-Clinical

Centene Corporation

Risk Adjustment Specialist engaging healthcare providers for Centene, which provides health plans and healthcare solutions. Analyzing data, training providers, and securing medical records for accurate chronic-condition documentation.

Posted 8/18/2026full-timeRemote • Texas, Washington • 🇺🇸 United StatesJuniorMid-Level💰 $23 - $40 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in provider engagement, training, and data analysis to enhance revenue management and compliance with state and federal guidelines. Proficient in using Excel and internal tools for reporting and strategy development.

Highest-signal resume keywords

Provider EngagementData AnalysisExcel ProficiencyHealth Insurance ExperienceProfessional Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Data AnalysisProvider EngagementTrainingReportingMedical Record Compliance

Soft Skills

Professional CommunicationOutreach Skills

Tools & Technologies

ExcelVendor PortalsInternal Systems

Industry Keywords

Health InsuranceChronic ConditionsRevenue ManagementState and Federal GuidelinesClaims

About the role

Key responsibilities & impact

Engage and educate providers on accurate capture and reporting of chronic conditions for revenue management
Ensure programs follow state and federal guidelines
Engage, train, and provide monthly reporting for 60–100 providers
Use data to develop strategies and best practices that help providers earn incentives and increase company revenue
Ensure medical records are received and work with vendors to overcome barriers
Ensure providers comply with mandated audits and medical record requests
Conduct outreach through phone, email, and Zoom meetings
Serve as point of contact for provider questions, reports, and issues throughout projects
Use Excel and internal tools to develop engagement, issue, and progress reporting
Review and analyze project data to identify barriers and develop provider-success strategies
Use vendor portals to identify barriers to receiving medical records for risk adjustment
Research provider information using internal systems and the internet
Outreach to provider offices and share best practices to obtain medical records for coding and abstraction

Requirements

What you’ll need

Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future
High School Diploma / GED
2 years of Health Insurance, Customer Service, Claims, or Provider Office experience required
Health Insurance experience preferred
10% in-state travel required
Experience with provider engagement, training, data analysis, and reporting
Proficiency with Excel and internal tools
Ability to use vendor portals, internal systems, and internet research
Professional oral and written communication skills
Ability to conduct outreach by phone, email, and Zoom meetings

Benefits

Comp & perks

Competitive pay
Health insurance
401K plans
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity