Remote Supervisor, Coding Analytics, Nationwide


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Business Area: Legal & Compliance
Job Type: Full time
Date Posted: Jun 04 2024
Job Number: 1500140


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.

Position Purpose: With the Payment Integrity team, you will oversee daily functions of the production team- from metrics (production and quality), coaching, workload delegation, and projects.

  • Ensure Coding Analytics team consistently meets production standards and passes quality audits
  • Oversee relationships with health plans, claims, and other departments resulting in a significant impact on Centene’s ability to meet key performance indicators
  • Identify and implement best practices and operational efficiencies
  • Serve as a health plan account liaison by lending expertise to code editing decisions
  • Research coding questions and issues. Provide expert testimony in state fair hearings and to leadership of health plans when discussing state complaints from providers
  • Triage and resolve escalated health plan, Claims department, and provider inquires and/or issues. Responsible for communication across IT, health plans, vendors, and all other affected departments

Education/Experience: Associate’s degree in Medical Billing and Coding, Healthcare, related field, or equivalent experience. 5+ years of account management, nursing, healthcare management, medical billing, or CPT coding, claims, coding analysis and trends, and/or data management experience.
Experience using code editing software systems in a managed care organization preferred.

Licenses/Certifications: Current state’s RN license or Certified Professional Coder (CPC) preferred.Pay Range: $67,400.00 – $121,300.00 per year

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.