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Coding Analytics Specialist I (Medical)

Chesterfield, Missouri Apply Now Job ID 1167306 Category Compliance Organization Centene Corporation Schedule Full-time
Description:
Position Purpose:

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 management

Compare provider billing and code auditing recommendations based on regulatory (Current Procedural Terminology) coding logic and state, CMS, and NCCI guidelines and rules

Investigate and process appeals and adjustments for claims denied in code editing software systems (HCI or CXT)

Maintain appropriate records, files, and documentation
Qualifications:
Validate correct coding recommendations against state, CMS, and NCCI guidelines, resulting in cost savings to Centene for pre-payment, adjustments, and appeals.

Education/Experience:
High school diploma or equivalent. 1+ years of medical billing/insurance, CPT coding, claims, coding analysis, or physician/hospital data management experience.

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.
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