Offer summary

Qualifications:

High school diploma or equivalent experience required., 4+ years of member services or claims experience needed., Experience in a managed care environment preferred., Familiarity with provider information systems is a plus..

Key responsibilities:

Collaborate with internal departments to analyze and resolve pended and denied encounters.

Facilitate the encounter resolution process to meet targets and deadlines.

Analyze operational procedures and recommend process improvements.

Research and resolve systemic issues impacting state compliance.

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.

Operating hours will be Monday through Friday, with a shift between 6:30am - 5pm Arizona time.

Position Purpose: Collaborate with internal departments to analyze and resolve pended and denied encounters based on state Medicaid guidelines. Identify and recommend process improvement.

Collaborate with internal departments to facilitate encounter resolution process to meet department and individual encounter resolution targets and deadlines.
Analyze current operational procedures, identify issues, and recommend process workflows or solutions, including automating processes and improving encounter resolution methodology.
Identify requirements for development projects and support activities.
Comply with prioritization process to reduce backlog of projects.
Research and resolve systemic issues that may impact state compliance.

Education/Experience: High school diploma or equivalent experience. 4+ years of member services or claims experience. Experience in a managed care environment with provider information systems preferred.

Pay Range: $22.79 - $38.84 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. Total compensation may also include additional forms of incentives.

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

Required profile