Remote Medical Coding Auditor - Claims & Compliance

Centene Corporation; Arizona; Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Remote or hybrid work schedules

Job summary

Centene Corporation is seeking a clinical coding reviewer to ensure accurate medical claim coding and compliance. The role involves analyzing billing practices, reviewing medical records, and coordinating with the Medical Director to improve policies and prevent errors.

The position emphasizes adherence to AMA/CMS guidelines, provider communication, and maintaining thorough records, with flexible work arrangements including remote/hybrid options as part of Centene’s comprehensive benefits.

Qualifications

• Associate’s degree or equivalent experience in a related field.
• Coding certification and 2+ years of experience in medical billing and coding.
• Experience in coding/data analysis or physician/hospital data management.
• Experience in provider communication and education preferred.

Responsibilities

• Analyze provider billing practices using code auditing software.
• Review medical records to ensure billing aligns with documentation.
• Consult with Medical Director to validate decisions.
• Identify potential billing errors, abuse, or fraud.
• Maintain records and ensure compliance with policies.

Skills

Medical coding

Billing & coding

Coding data analysis

Provider communication

Regulatory compliance

Education

Associate’s degree or equivalent

Coding certification

Job description

Centene Corporation is seeking a clinical coding reviewer to ensure accurate medical claim coding and compliance. The role involves analyzing billing practices, reviewing medical records, and coordinating with the Medical Director to improve policies and prevent errors.

The position emphasizes adherence to AMA/CMS guidelines, provider communication, and maintaining thorough records, with flexible work arrangements including remote/hybrid options as part of Centene’s comprehensive benefits.