Claims Research Specialist jobs in United States
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Centene Corporation ยท 7 hours ago

Claims Research Specialist

positionUnited States
timeFull-time
remoteRemote
seniorityMid Level
money$23.23/hr - $39.61/hr
date3+ years exp

Centene Corporation is transforming the health of communities, serving 28 million members. The Claims Research Specialist will act as a liaison to investigate and resolve claims inquiries, ensuring data integrity and educating providers on claims processes.

Hospital & Health Care
badNo H1BnoteU.S. Citizen Onlynote

Responsibilities

Receive and respond to internal and external claims related issues
Initiate entry or change of provider related database information
Complete claims related research projects
Assist with responsibilities related to data integrity of provider claims processing system
Investigate and communicate reimbursement and benefit changes
Educate provider relations, provider services and claims liaisons regarding policies and procedures related to referrals and claims submission
Assist providers with resolving issues with claims submission and payment accuracy
Attend state meetings with regards to fee schedule and benefit changes
Assist with provider complaints & resolutions regarding claims issues and process claims adjustments
Review all Medicaid Bulletins for changes and updates and submit change requests (CRs) to update payment system

Qualification

Claims payment processingMedicaid benefits knowledgeData integrity managementCustomer serviceCommunication skills

Required

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
High school diploma or equivalent
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
Customer service experience

Preferred

Bachelor's degree

Benefits

Competitive pay
Health insurance
401K and stock purchase plans
Tuition reimbursement
Paid time off plus holidays
A flexible approach to work with remote, hybrid, field or office work schedules

Company

Centene Corporation

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Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
dateFounded in 1984
location
Saint Louis, MO, US
people-size10001+ employees
web-link
http://www.centene.com

Funding

Current Stage
Late Stage

Leadership Team

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Beth Johnson
President and CEO, Coordinated Care
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Clyde White
President & CEO (New Hampshire Healthy Families)
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Recent News

Business Journals
Judge rules lawsuit alleging Centene fraud can proceed
2024-05-06
FierceHealthcare
Centene offers look at its Medicaid strategy in 2024
2024-04-28
Forbes
Centene Profits Eclipse $1 Billion Thanks To Big Obamacare Enrollment
2024-04-28
Company data provided by crunchbase