Coding Analytics Specialist I (Medical)

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: Validate correct coding recommendations against state, CMS, and NCCI guidelines, resulting in cost savings to Centene for pre-payment, adjustments, and appeals.Accept or reject coding recommendations based on provider documentation, administrative policies, regulatory codes, legislative directives, precedent or other guidelines under the guidance of senior team members or managementCompare provider billing and code auditing recommendations based on regulatory (Current Procedural Terminology) coding logic and state, CMS, and NCCI guidelines and rulesInvestigate and process appeals and adjustments for claims denied in code editing software systems (HCI or CXT)Maintain appropriate records, files, and documentationEducation/Experience:

High school diploma or equivalent. 1+ years of medical billing/insurance, CPT coding, claims, coding analysis, or physician/hospital data management experience.Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.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.TITLE: Coding Analytics Specialist I (Medical)LOCATION: Various, FloridaREQNUMBER: 1423617