Supervisor, Payment Integrity- Coding & Clinical (DRG)
Centene
Missouri
Workplace: RemoteFull timeUSD 87,700 - 157,800 annuallyFunction: Quality & Regulatory (Non-Software)Experience: 6+ yearsEducation: bachelorsSkills: ["Leadership","Quality assurance","Attention to detail","Data analysis","Cross-functional collaboration"]Supervise and coordinate the day-to-day work of a Coding & Clinical Review team within Payment Integrity, ensuring accurate DRG assignment, clinical validation, and audit outcomes. Lead quality assurance activities like audits, calibration sessions, and inter-rater reliability reviews, and support appeals by reviewing documentation and guiding responses. Monitor performance, resolve complex escalations, analyze audit data for trends, and drive compliant execution of coding and clinical standards aligned with ICD-10-CM/PCS and AHIMA ethics.
