Live chat
Centene Corporation

Provider Reimbursement Auditor (Claims Auditor)

Centene Corporation - Farmington, MO

Job ID 1080904Date posted 02/12/2018Category Claims OperationsOrganization G&A-Audit-InternalSchedule Full-timeDescription:Position Purpose: Perform comprehensive audits of provider claims to source documents and identify mis-payments. Conduct quality audits of provider claims, pre and post payments, utilizing appropriate sources of information, including eligibility, enrollment, state contracts, provider and facility contracts, and state and health plan billing manualsAnalyze errors and determine root causes for appropriate classificationUtilize audit software to provide written documentation regarding audit observationsAnalyze and review responses to audit observations and facilitate corrective action plansAssist with providing updates to audit criteriaQualifications:Education/Experience: Associate’s degree in related field or equivalent experience. 2 years of medical or pharmacy claims processing or claims pricing experience. Microsoft Office applications, Medicaid and Medicare reimbursement rules and the ability to interpret state and provider contracts preferred. Knowledge of CPT/HCPCS Coding preferred.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.

10 days 7 hours ago

Centene Corporation


Provider Reimbursement Auditor (Claims Auditor) Centene Corporation - Farmington, MO, United States


Location: Farmington, MO

Company Profile:
Founded as a single health plan in 1984, Centene Corporation (Centene) has established itself as a national leader in the healthcare services field. Today, through a comprehensive portfolio of innovative solutions, we remain deeply committed to delivering results for our stakeholders: state governments, members, providers, uninsured individuals and families, and other healthcare and commercial organizations