Claims Analyst II - Complex Medical Claims (Remote)

Centene Management Company LLC; Missouri; Hybrid; USD 40,000 - 69,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Job summary

Centene Management Company LLC in Missouri is seeking a claims processor to ensure timely processing of complex pending medical claims, verify information, and determine reimbursement eligibility.

The role requires a high school diploma, 2+ years of health insurance or claims experience, basic math, and knowledge of ICD-9/10, CPT and HCPCS codes; Amisys or Facets experience is a plus. Flexible remote/hybrid/office schedules available.

Qualifications

• High school diploma or equivalent required.
• 2+ years health insurance or claims experience required.
• Intermediate PC and Microsoft Office skills; basic math proficiency required.

Responsibilities

• Process complex pending medical claims and ensure timely payments/denials.
• Verify and update claim information; apply policies and provider contracts.
• Determine if claims are payable, require additional information, or should be denied.
• Research status of medical-related claims and respond to stakeholders.
• Maintain records and meet department production and quality standards.

Skills

Microsoft Office

Basic math

Education

High school diploma

Associate degree preferred

3+ years claims processing (external candidates)

Tools

Amisys

Facets

Job description

Centene Management Company LLC in Missouri is seeking a claims processor to ensure timely processing of complex pending medical claims, verify information, and determine reimbursement eligibility.

The role requires a high school diploma, 2+ years of health insurance or claims experience, basic math, and knowledge of ICD-9/10, CPT and HCPCS codes; Amisys or Facets experience is a plus. Flexible remote/hybrid/office schedules available.