17 Nov

Claims Analyst Jobs Vacancy in Centene Corporation Rancho Cordova

Position
Claims Analyst
Company
Centene Corporation
Location
Rancho Cordova CA
Opening
17 Nov, 2018 24 days ago

Centene Corporation Rancho Cordova urgently required following position for Claims Analyst. Please read this job advertisement carefully before apply. There are some qualifications, experience and skills requirement that the employers require. Does your career history fit these requirements? Ensure you understand the role you are applying for and that it is suited to your skills and qualifications.

Follow the online directions, complete all the necessary fields, and provide all relevant information so your application is submitted correctly. When you click the 'Apply this Job' button (open in new window) you will be taken to the online application form. Here you will be asked to provide personal and contact details, respond to employment-related questions, and show how you meet the key selection criteria.

Claims Analyst Jobs Vacancy in Centene Corporation Rancho Cordova Jobs Details:

    Process pended medical claims, verifying and updating information on submitted claims and reviewing work processes to determine reimbursement eligibility. Ensure payments and/or denials are made in accordance with company practices and procedures.
  • Apply policy and provider contract provisions to determine if claim is payable, if additional information is needed, or if claim should be denied. Claims processing may be related to physician and hospital services, coordination of benefits (COB), high dollar, special pricing, refunds and/or adjustments on resubmitted claims.
  • Research and determine status of medical related claims
  • Review charges, access the computer system and use payment or denial codes within established department guidelines and standards
  • Clarify health insurance coverage for coordination of benefits to process claims
  • Maintain records, files, and documentation as appropriate
  • Meet department production and quality standards
Qualifications:

Education/Experience: High school diploma or equivalent. 1+ years of claims processing, medical billing, administrative, customer service, call center, or physician’s office or other office services experience. Experience operating a 10-key calculator and computers. Ability to perform basic math functions and reason logically. Working knowledge of ICD-9, CPT, HCPCs, revenue codes, and medical terminology preferred. Experience with Medicaid or Medicare claims preferred.

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.


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