Coding Auditor Trainer

Overview

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.

Applicants for this role will have the flexibility to work remotely anywhere in the continental United States. AMISYS experience highly preferred.

Position Purpose

Audit medical record coding to ensure high dollar claims are processed appropriately and to identify training needs. Ensure department policies and procedures support uniform processing.

Responsibilities

• Audit high dollar claim processing by coding analysts for accuracy and completeness
• Prepare and draft audit reports of findings and recommendations for action plans in response to observed deficiencies
• Research state specific regulations and evaluate internal processes and / or controls to identify non-compliance issues and improvement opportunities
• Analyze audit results to identify training needs for coding analyst staff
• Train new coding analysts and existing coding analysts on new functions and health plans
• Evaluate audit results and develop training to improve the accuracy of high dollar claim processing
• Develop and revise department policies and procedures in accordance with all Federal and State regulations
• Performs other duties as assigned
• Complies with all policies and standards

Qualifications

Education / Experience : Associate's degree in Audit, Accounting, or related field or equivalent experience. 2+ years of medical billing, coding, or claims processing experience. Knowledge of billing practices for hospitals, physicians and / or ancillary providers as well as knowledge about contracting and claims processing. Previous managed care, state and / or federal health care programs (i.e., Medicaid, Medicare) or health insurance industry experience.

Benefits

Pay Range : $55,100.00 - $99,000.00 per year

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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

EEO Statement

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

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