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Centene Corporation

Transforming the health of the communities we serve, one person at a time.

Coding Business Analyst II – Content Updates

Business AnalystBusiness AnalystFull TimeRemoteMid LevelTeam 10,001+Since 1984H1B No SponsorCompany SiteLinkedIn

Location

Arizona + 4 moreAll locations: Arizona | Illinois | North Carolina | Michigan | Missouri

Posted

9 days ago

Salary

$56.2K - $101K / year

Seniority

Mid Level

Bachelor Degree2 yrs expExperience acceptedEnglish

Job Description

Coding Business Analyst II – Content Updates

Centene Corporation

• Perform various analysis and interpretation to link business needs and objectives for assigned function • Ensuring our internal claims coding editors remain accurate, up to date, and compliant • Review, analyze, and interpret coding, reimbursement, and regulatory guidelines to ensure organizational compliance and payment integrity • Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic to support accurate claims adjudication • Monitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation • Identify ways to enhance performance management and operational reports related to new business implementation processes • Develop and incorporate organizational best practices into business applications • Lead problem solving and coordination efforts between various business units • Assist with formulating and updating departmental policies and procedures • Performs other duties as assigned

Job Requirements

  • Bachelor’s degree in related field or equivalent experience
  • 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience
  • Knowledge of managed care information systems and experience in benefits, pricing, contracting or claims preferred
  • Knowledge of provider reimbursement methodologies preferred
  • Previous structured testing experience preferred
  • Coding certification such as a CPC or similar
  • Claims coding appeals and auditing experience
  • Claims research experience
  • Excel skills with pivot tables and VLOOKUPs

Benefits

  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • flexible approach to work with remote, hybrid, field or office work schedules

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