May 30, 2023
You could be the one who changes everything for our 26 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: Serve as the claims payment and claims configuration expert for plan and various departments to effectively identify and resolve claims issues. Act as the subject matter expert for the claims payment structure.Audit check run and send claims to the claims department for corrections. Collaborate with the claims department to price pended claims correctly. Identify authorization issues and trends and research for potential configuration related work process changes.Collaborate with various business units to resolve claims issues to ensure prompt and accurate claims adjudication. Document, track and resolve all plan providers claims projects. Research the claims on various reports to...
Sunshine State Health Plan
Remote * (Tallahassee, FL, USA)