Skip to content

 

Chesterfield, Missouri - USD Full Time Posted: Thursday, 12 October 2017
 
 
Position Purpose:

Ensure Coding Analytics team consistently meets production standards and passes quality audits

Oversee relationships with health plans, claims, and other departments resulting in a significant impact on Centene's ability to meet key performance indicators

Identify and implement best practices and operational efficiencies

Serve as a health plan account liaison by lending expertise to code editing decisions

Research coding questions and issues. Provide expert testimony in state fair hearings and to leadership of health plans when discussing state complaints from providers

Triage and resolve escalated health plan, Claims department, and provider inquires and/or issues. Responsible for communication across IT, health plans, vendors, and all other affected departmentsLead clinical coding compliance nurses and non-clinical team members through the code editing adjudication process that includes prepay compliance, adjustments, and appeals for multiple code editing software systems.

Education/Experience:

Associate's degree in Medical Billing and Coding, Healthcare, related field, or equivalent experience. 5 years of account management, nursing, healthcare management, medical billing, or CPT coding, claims, coding analysis and trends, and/or data management experience.

Experience using code editing software systems in a managed care organization preferred.

Licenses/Certifications: Current state's RN license or Certified Professional Coder (CPC) preferred.

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.

SDL2017



Chesterfield, Missouri, United States of America
IT
USD
Centene Corporation
Centene Corporation
JS2124_E7C20723845733D909508F58E0C8EACA_228_I/282282589
10/12/2017 12:23:04 PM

We strongly recommend that you should never provide your bank account details to an advertiser during the job application process. Should you receive a request of this nature please contact support giving the advertiser's name and job reference.