Job Description
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.
This opening will support Claims Rework or Claims Projects. Anyone applying to this position will be in consideration for all openings.
**Position Purpose:**
Ensure timely processing of complex pending medical claims. Verify and update information on the submitted claims. Review work processes to determine reimbursement eligibility. Ensure payments and/or denials are made in accordance with company practices and procedures.
+ Process first time claims with added complexity
+ Apply policy and provider contract provisions to determine if claim is payable, if additional information is needed, or if claim should be denied
+ Research and determine status of medical relate...
This opening will support Claims Rework or Claims Projects. Anyone applying to this position will be in consideration for all openings.
**Position Purpose:**
Ensure timely processing of complex pending medical claims. Verify and update information on the submitted claims. Review work processes to determine reimbursement eligibility. Ensure payments and/or denials are made in accordance with company practices and procedures.
+ Process first time claims with added complexity
+ Apply policy and provider contract provisions to determine if claim is payable, if additional information is needed, or if claim should be denied
+ Research and determine status of medical relate...