Risk Adjustment Specialist (Non-Clinical)

Centene
Washington, Texas
Workplace: RemoteFull timeUSD 23.23 - 39.61 hourlyFunction: Legal, Risk & ComplianceExperience: 2+ yearsEducation: high_schoolSkills: ["Communication","Outreach","Training","Data analysis","Problem-solving"]

Engage and educate health care providers to ensure accurate capture and reporting of chronic conditions for risk adjustment and revenue management. You’ll outreach to 60–100 providers, deliver training, and provide monthly reporting using Excel and internal tools. Analyze project data to remove barriers, coordinate with vendors for medical record requests, and support compliance with state and federal program guidelines, including mandated audits.

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FursaFursa
Centene
Centene
23 hours ago

Risk Adjustment Specialist (Non-Clinical)

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Source: Company careers pageValidated by: Fursa AI
Last checked: 5 hours agoStatus: Live

Job Summary

Engage and educate health care providers to ensure accurate capture and reporting of chronic conditions for risk adjustment and revenue management. You’ll outreach to 60–100 providers, deliver training, and provide monthly reporting using Excel and internal tools. Analyze project data to remove barriers, coordinate with vendors for medical record requests, and support compliance with state and federal program guidelines, including mandated audits.
Location: Washington, Texas
Workplace: Remote
Employment Type: Full time
Job Function: Legal, Risk & Compliance
Seniority: Mid level

Key Responsibilities

  • •Outreach and engage 60–100 providers, serving as point of contact for questions, reports, issues, and requirements to earn incentives.
  • •Train providers and ensure accurate capture and documentation of chronic conditions for risk adjustment revenue management.
  • •Use Excel and internal tools to create reporting on engagement, issues, and progress to help providers meet goals.
  • •Review and analyze project data to identify barriers and develop strategies and best practices for provider success.
  • •Coordinate medical record receipt and work with vendors/portals to overcome barriers and support compliant medical record requests and mandated audits.
Travel: Low travel

Pay and Benefits

Salary: USD 23.23 - 39.61 hourly
Perks:Health Insurance401kEquityPaid LeavePaid Holidays

Key Requirements

  • •High School Diploma / GED.
  • •2 years of Health Insurance, Customer Service, Claims, or Provider Office experience.
  • •Health Insurance experience preferred.
  • •Ability to use Excel and internal tools to develop engagement and progress reporting.
  • •Professional oral and written communication skills to educate providers via phone, email, and Zoom.
Experience:2+ yearsHealth insuranceHealthcareCustomer serviceClaimsProvider office
Education:High School
Skills:CommunicationOutreachTrainingData analysisProblem-solving
Tech Stack:ExcelZoomVendor portals

Eligibility

Visa:H-1BL-1O-1H-1B1F-1J-1OPTCPT
Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn