Remote Medical Coding Reviewer & Policy Auditor

Centene; Missouri; Remote; USD 42.000 - 62.000; Vollzeit

Benefits dieser Stelle

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules (remote,hybrid

Zusammenfassung

Centene is seeking a Medical Coding Reviewer I to perform clinical and coding medical claim reviews ensuring compliance with coding practices. This role fits candidates with medical billing and coding backgrounds who are detail-oriented and analytical.

The position offers remote work options in Missouri with a full-time day shift. You will engage in code auditing, review records for billing consistency, and collaborate with the Medical Director to support policy creation and coding questions.

Qualifikationen

• 2+ years of experience in medical billing & coding, coding/data analysis, or related clinical experience.
• Associate's degree in related field or equivalent experience.

Aufgaben

• Analyze provider billing practices using code auditing software and regulatory codes.
• Review medical records for consistency with billing for appeals and adjustments.
• Collaborate with the Medical Director to validate decisions and create medical policy.
• Assist with research of health plan coding questions.
• Identify potential billing errors, abuse, and fraud.
• Flag cases for potential prepayment review.
• Maintain appropriate records and documentation.
• Perform other duties as assigned.
• Comply with all policies and standards.

Kenntnisse

Medical billing & coding

Data analysis

Regulatory codes

Ausbildung

Associate's degree or equivalent experience

Tools

Code auditing software

Jobbeschreibung

Centene is seeking a Medical Coding Reviewer I to perform clinical and coding medical claim reviews ensuring compliance with coding practices. This role fits candidates with medical billing and coding backgrounds who are detail-oriented and analytical.

The position offers remote work options in Missouri with a full-time day shift. You will engage in code auditing, review records for billing consistency, and collaborate with the Medical Director to support policy creation and coding questions.