Centene Corporation
Centene Corporation
Centene Corporation एक स्वास्थ्य सेवा और बीमा कंपनी है, जो सरकार द्वारा प्रायोजित कवरेज और सामुदायिक स्वास्थ्य पर केंद्रित है। इसकी सेवाओं में Medicaid, Medicare, Health Insurance Marketplace योजनाएँ और सैन्य समुदायों के लिए TRICARE सहायता शामिल हैं। Centene अपने सदस्यों की आवश्यकताओं को पूरा करने के लिए स्थानीय स्तर पर स्वास्थ्य सेवाएँ उपलब्ध कराने को गैर-लाभकारी संगठनों के साथ साझेदारियों से जोड़ती है। कंपनी अपने संचालन और समुदायों के समर्थन के दृष्टिकोण में पर्यावरणीय जिम्मेदारी और नैतिक शासन को भी शामिल करती है।

Payment Integrity Analyst II – Remote

Analyze healthcare claims, business processes, and requirements for Centene’s payment integrity initiatives. Support data analysis, system testing, reporting, and process improvement in a remote role.

विवरण

  • Analyze and interpret information to connect business needs with objectives for the assigned function
  • Support business initiatives with data analysis
  • Identify implementation obstacles and perform user acceptance testing for new systems
  • Review user requirements, procedures, and issues to improve existing processes
  • Conduct in-depth analysis for assigned projects
  • Recommend business solutions and support their implementation
  • Improve performance management and operational reporting for new business implementation processes
  • Apply organizational best practices within business applications
  • Lead problem-solving and coordination across business units
  • Help develop and maintain departmental policies and procedures
  • Complete additional duties as assigned
  • Follow all applicable policies and standards

आवश्यकताएँ

  • Bachelor’s degree in a related field or equivalent professional experience
  • At least two years of business process analysis experience, preferably in healthcare or claims payment and analysis
  • Payment integrity or healthcare claims auditing experience is preferred
  • Medical coding certification is preferred
  • Strong analytical and root cause analysis capabilities are preferred
  • Excel proficiency is preferred
  • Experience with ticketing systems is preferred
  • Knowledge of managed care information systems is preferred
  • Experience with benefits, pricing, contracting, or claims is preferred
  • Knowledge of provider reimbursement methodologies is preferred
  • Prior experience with structured testing is preferred
  • Ability to document business processes and collect requirements
  • Ability to comply with all policies and standards

लाभ

  • Competitive compensation
  • Health insurance
  • 401(k) plan
  • Employee stock purchase plans
  • Tuition reimbursement
  • Paid time off and holidays
  • Flexible remote, hybrid, field, or office work arrangements
  • Additional incentives may form part of total compensation
  • Equal opportunity employer with a commitment to diversity

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