Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Provides administrative and analytical support for all check run cycles, researches and resolves provider payment issues, monitors unclaimed property, and assists in fee schedule and DRG analysis with review of fluctuations. Compile and analyze weekly claim runs to explain variances and fluctuations. Assist in performing DRG analyses for appropriate payment determination. Assist in creating financial impact analysis related to shifts in State and Federal premium and rate methodologies. Create spreadsheets with appropriate data to provide others with organized statistical reports or graphs. Transcribe, format, input, edit, retrieve, copy, and transmit text, data, and graphics to produce documents and presentations. Work collaboratively with accounting unit to place stop payments, update provider relations department on the status of replacements. Log provider refund checks. Answer CSI inquiries on daily basis Supply information to Claims Department. Interpret and enter provided information from the Claims department. Follow up to ensure resolution. Work with I.T. for accurate and timely issuance of Form 1099 and state requirements regarding unclaimed property. Performs other duties as assigned Complies with all policies and standards Education/Experience: AA/AS - Associates Degree or equivalent, required. Two years managed care and healthcare experience, preferred. Pay Range: $19.04 - $32.35 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law , including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act #J-18808-Ljbffr Centene

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