Skip Navigation

As part of the Customer Service department, you’ll use your knowledge of Centene’s insurance products and service to help our members understand their benefits, details and policy procedures. With your skills, you can help transform the health of every community, one person at a time.

Back to Job Navigation (Overview)

What does it take?

What are the qualities that will help you achieve success in this role at Centene?

Success Profile

  • Detail-oriented
  • Organized
  • Proactive
  • Positive
  • Trustworthy
  • Consistent

Back to Job Navigation (Success)

Quote

“I enjoy knowing that by doing my job efficiently, our providers can focus on giving the best care to the members we serve.”

- Kim Joyce, Claims Analyst

“Centene has been instrumental in my professional development. I’m pushed in a way that challenges my fears, improve my skills, and enhance my knowledge on healthcare.”

- Meaghan Hooks, Business Analyst II

“My job has a direct impact on our providers and members. With every claim paid out the door we are directly helping to save someone’s life!”

- Jonelle Levy, Business Analyst II

Back to Job Navigation (Testimonials)

Responsibilities

Job ID 1130270

Category Claims Operations
Schedule Full-time
Description:
Position Purpose:

Develop the vision and goals for the claims department in compliance with federal, state and Company guidelines
Oversee and ensure achievement and maintenance of all claims processing standards within established guidelines
Partner with multiple business units, health plans and other stakeholders to establish operational objectives and procedures.
Identify business needs and drive change initiatives to address these issues
Ensure all issues are resolved accurately and timely and implement action plans to address any issues
Identify and implement operational efficiencies and development of “best practice” policies and procedures
Analyze customer impact and respond to complex escalated customer service and claims processing issues to ensure that customer expectations are consistently met
Qualifications:
Direct the day-to-day operations of the claims department and ensure accurate and timely processing of members medical claims within established state and company compliance guidelines.

Education/Experience:
Bachelor’s degree or equivalent experience. 7+ years of operations management, financial management or analysis, or claims operations experience, preferably in a managed care and/or Medicaid setting. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

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.
Apply Now

Check out this location

See what's near our Tyler location.

View Map

Back to Job Navigation (Map)

Our Customer Service Roles

Claims Analyst

As part of a tight-knit team and working as a partner to each provider, you’ll evaluate the needs of your health plan and process all claims in accordance with guidelines.

Claims Liaisons

While ensuring that provider and member requests are taken care of, you’ll review requests from providers and work with state health plans to ensure the accuracy and quality of claims.

Customer Service Representative

You’ll use your healthcare knowledge, analytical skills and our information resources to quickly and correctly answer questions from members and providers.

Enrollment Analyst

You’ll process incoming membership files and focus on maintaining the enrollment integrity of our individual health plan systems.

Systems Solutions Manager

While leading a team of business analysts, you’ll work with the IT department to drive end-to-end solutions for core applications supporting Centene’s operations. Claims Analyst.

Back to Job Navigation (Our Customer Service Roles)

Our Awards

Centene is consistently recognized for how well we treat our members, our people, and the communities we serve.

Honored to be Honored

Back to Job Navigation (Our Awards)

Our Hiring Process

Learn more about our hiring process and discover other helpful information for applicants.

Learn More
“Centene is an exciting company to work for.”

Esmeralda Baig

Started as a Case Manager, now a Senior Vice President of Operation

See Esmeralda's career path

Sign up for Job Alerts

Join our Talent Network and get Centene news and job alerts delivered to your inbox.

Areas of InterestSearch for a category, location, or category/location pair, select from the suggestions and click “Add”.

  • Claims Operations, Tyler, Texas, United StatesRemove
  • Leadership, Tyler, Texas, United StatesRemove

Back to Job Navigation (Job Alerts)

Match Your Skills

Let us search jobs for you based on the skills and experience listed in your LinkedIn Profile.

Start Matching