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Transforming the health of the communities we serve, one person at a time.
Business Analyst II – Coding
Location
Missouri
Posted
9 days ago
Salary
$56.2K - $101K / year
Seniority
Mid Level
Job Description
Business Analyst II – Coding
Centene Corporation
• Perform various analysis and interpretation to link business needs and objectives for assigned function • Responsible for payment integrity repository updates and ensuring it remains up to date and accurate • 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 • Complies with all policies and standards
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 preferred
- Claims coding research experience preferred
- Excel skills with pivot tables and VLOOKUPs preferred
- Smartsheet experience preferred
- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship
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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