Job ID 008X7Date posted 02/08/2018Category Claims OperationsOrganization G&A-Claims-FergusonSchedule ContingentDescription:Apply policy and provider contract provisions to determine if claim is payable, if additional information is needed, or if claim should be denied. Claims processing may be related to physician and hospital services, coordination of benefits (COB), high dollar, special pricing, refunds and/or adjustments on resubmitted claims. Research and determine status of medical related claims Review charges, access the computer system and use payment or denial codes within established department guidelines and standards Clarify health insurance coverage for coordination of benefits to process claims Maintain records, files, and documentation as appropriate Meet department production and quality standardsQualifications:High school diploma or equivalent. 1 years of claims processing, medical billing, administrative, customer service, call center, or physician?s office or other office services experience. Experience operating a 10-key calculator and computers. Ability to perform basic math functionsand reason logically. Knowledge of ICD-9, CPT, HCPCs, revenue codes, and medical terminology preferred. Experience with Medicaid or Medicare claims preferred.PART-TIME ROLE FROM 5:00 PM TO 9:00 PM - MONDAY TO FRIDAYCentene 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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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