Remote Clinical Coding Quality Analyst

Centene Management Company LLC; Town of Texas (WI); Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Paid time off

Job summary

Centene Management Company LLC is seeking a Coding Quality Coordinator II to perform complex reviews of clinical documentation in inpatient and outpatient records, validate coding accuracy, and determine appropriate payment methods. The role requires DRG and ICD-10-CM/PCS coding experience, RHIA/RHIT/CCS/CCA/CPC credentials preferred, and the ability to communicate findings to providers and leadership.

You will contribute to ongoing educational programs and ensure compliance with official

Qualifications

• AA in Health Information Technology preferred.
• Two years experience with DRG, ICD-9-CM/ICD-10-CM/PCS, CPT, HCPCS coding.

Responsibilities

• Perform complex reviews of clinical documentation for inpatient and outpatient records.
• Validate coding accuracy and payment methodology; prepare written rationale.
• Respond to providers and participate in ongoing coding education.
• Identify patterns of possible fraud or abuse and refer for action.

Skills

DRG experience

ICD-9/ICD-10 coding

CPT/HCPCS coding

Education

Associate degree in Health Information Technology

Job description

Centene Management Company LLC is seeking a Coding Quality Coordinator II to perform complex reviews of clinical documentation in inpatient and outpatient records, validate coding accuracy, and determine appropriate payment methods. The role requires DRG and ICD-10-CM/PCS coding experience, RHIA/RHIT/CCS/CCA/CPC credentials preferred, and the ability to communicate findings to providers and leadership.

You will contribute to ongoing educational programs and ensure compliance with official