Medical Coding Reviewer I

Centene Corporation; Georgia (VT); Remote; Full time

Job summary

Join a leading healthcare organization as a Medical Coding Reviewer I. This remote position focuses on ensuring accurate medical coding and billing practices, impacting the health of millions. Responsibilities include reviewing claims, collaborating with medical directors, and ensuring compliance with coding standards. Ideal candidates will have relevant experience and certifications, along with a commitment to quality and accuracy.

Benefits

Health Insurance

401K

Stock Purchase Plans

Tuition Reimbursement

Paid Time Off

Flexible Work Arrangements

Qualifications

• At least 2 years of relevant experience in medical billing, coding, or clinical data management.
• Valid LPN, RN, CPC, CCS, RHIT, RHIA, CPMA, or Paramedic certification.

Responsibilities

• Perform clinical and coding medical claim reviews for compliance.
• Analyze provider billing practices and identify billing errors.

Skills

Medical Billing

Coding Compliance

Provider Communication

Education

Associate's Degree

Tools

CPC

CCS

RHIT

RN

LPN

Job description

Join Our Team as a Medical Coding Reviewer I at Centene Corporation

Centene Corporation is seeking a Medical Coding Reviewer I to join our Medical Management/Health Services team. This remote position offers an opportunity to impact the health of 28 million members by ensuring accurate medical coding and billing practices.

Position Purpose

Perform clinical and coding medical claim reviews to ensure compliance with coding standards, regulatory requirements, and company policies. Responsibilities include analyzing provider billing practices, reviewing medical records, collaborating with Medical Directors, researching coding questions, and identifying billing errors or potential fraud.

Qualifications

• Associate’s degree or equivalent experience in a related field
• Coding certification (e.g., CPC, CCS, RHIT, RN, LPN) and at least 2 years of relevant experience in medical billing, coding, or clinical data management
• Experience in provider communication and education is preferred

License/Certification

Valid LPN, RN, CPC, CCS, RHIT, RHIA, CPMA, or Paramedic certification

Additional Details

• Position Type: Full-time
• Location: Remote
• Pay Range: $26.50 - $47.59 per hour

Benefits

Competitive benefits package including health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off, and flexible work arrangements.

Equal Opportunity Statement

Centene is committed to diversity and equal employment opportunity. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.