Claims Analyst

Centene
Florida, Missouri, North Carolina, Texas
Workplace: RemoteFull timeUSD 15.87 - 27.25 hourlyFunction: Insurance & ActuarialExperience: 1+ yearsEducation: high_schoolSkills: ["Basic math","Record keeping","Attention to detail","Process adherence"]

Process pending medical claims to ensure timely reimbursement decisions. Verify and update submitted claim information, review claim work processes for reimbursement eligibility, and determine whether claims are payable based on policy and provider contract provisions. Research claim status, maintain accurate documentation, and meet department production and quality standards. Complete progressive claims training programs as required.

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FursaFursa
Centene
Centene
1 day ago

Claims Analyst

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 11 hours agoStatus: Live

Job Summary

Process pending medical claims to ensure timely reimbursement decisions. Verify and update submitted claim information, review claim work processes for reimbursement eligibility, and determine whether claims are payable based on policy and provider contract provisions. Research claim status, maintain accurate documentation, and meet department production and quality standards. Complete progressive claims training programs as required.
Location: Florida, Missouri, North Carolina, Texas
Workplace: Remote
Employment Type: Full time
Job Function: Insurance & Actuarial
Seniority: Mid level

Key Responsibilities

  • •Process first-time medical claims and ensure timely processing of pending claims.
  • •Verify and update information on submitted claims and apply policy and provider contract provisions to determine payability.
  • •Research and determine the status of medical-related claims.
  • •Maintain records, files, and documentation as appropriate and meet production and quality standards.
  • •Complete progressive claims training programs as required and perform other assigned duties while complying with policies and standards.

Pay and Benefits

Salary: USD 15.87 - 27.25 hourly
Equity and Bonus:Equity
Perks:Health Insurance401kPaid LeaveEquityRemote Work

Key Requirements

  • •High school diploma or equivalent.
  • •1 year of health insurance industry, claims processing, physician’s office, or other office services experience.
  • •Proficiency using computers and Microsoft Office (Word, Excel, etc.).
  • •Ability to perform basic math functions.
  • •Working knowledge of ICD-9/10, CPT, HCPCs, revenue codes, and medical terminology; Medicaid or Medicare claims experience preferred.
Experience:1+ yearsHealth insuranceClaims processing
Education:High School
Skills:Basic mathRecord keepingAttention to detailProcess adherence
Tech Stack:Microsoft OfficeWordExcelAmisysXcelysICD-9ICD-10CPTHCPCs

Eligibility

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