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.
Position Purpose: Analyze, execute, and review bulk requests for claims automation including validating eligibility for automation, to ensure accuracy of claims data upon project completion. Update/create new automation technology. Review, investigate, adjust/resolve claims, claims appeals, inquiries, and inaccuracies in payment of claims. Also, support all internal and external customers with automation questions/issues and escalated requests.
- Analyzes requests for eligibility for BOT/Macro automation that are received from either CCP (Cenpas Claims Projects) or direct Ad-hoc requests from the business on SharePoint. Questions or concerns with project instructions are sent to the Claims Process Review (CPR)/Claims Liaison (CL)/or requestor.
- Executes request by submitting analyzed requests to the BOT or Macro Automation tools. Monitors and corrects identified for errors along the way
- Once Automation request have finished, review for accuracy is completed. Identified errors are corrected. Results, ineligible, and fallout claims are reported, and project moved to the next step of manual team or closure.
- Support all internal and external customers with questions/concerns by reviewing, investigating, adjusting claims, claims appeals, inquiries, and/or inaccuracies in payment of claims projects worked.
- Updating/creating new automation technology.
Education/Experience: High school diploma or equivalent. 2+ year of claims related, claim processing or medical billing experience. Working knowledge of Microsoft Office applications. Advanced Macro Express knowledge and technical background preferred.
Travel: Minimum or as needed.Pay Range: $18.66 - $31.73 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Top Skills
What We Do
Centene provides healthcare solutions to individuals across the United States with more than 23 million members nationwide.
