Supervisor, Payment Integrity - Appeals & Disputes

Centene Corporation; Missouri; Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Job summary

Centene Corporation in Missouri seeks a Coding Analytics professional to ensure production standards, oversee health plan relationships, and drive coding quality across IT, claims, and related departments. The role requires an Associate’s degree and 5+ years in account management, nursing, healthcare management, medical billing, or CPT coding; RN or CPC certification preferred.

Salary: $70,100–$126,200/year with comprehensive benefits.

Qualifications

• Associate’s degree in medical billing, healthcare, or related field with 5+ years in account management or coding analytics.
• Experience with CPT coding, claims, and data management in managed care preferred.
• RN license or CPC certification preferred.

Responsibilities

• Ensure Coding Analytics team meets production standards and audits.
• Oversee health plan relationships impacting KPIs.
• Identify best practices and operational efficiencies.
• Serve as liaison on code editing decisions and research coding questions.
• Provide expert testimony in hearings and leadership discussions.
• Triages and resolves escalated health plan and provider inquiries.
• Communicate across IT, health plans, vendors, and affected departments.
• Perform other duties and adhere to policies.

Skills

Account management

Healthcare management

Nursing

Medical billing

CPT coding

Claims analysis

Data management

Education

Associate’s degree

Tools

Code editing software

Job description

Position Purpose:

• Ensure Coding Analytics team consistently meets production standards and passes quality audits.
  
• Oversee relationships with health plans, claims, and other departments resulting in a significant impact on Centene’s ability to meet key performance indicators.
  
• Identify and implement best practices and operational efficiencies.
  
• Serve as a health plan account liaison by lending expertise to code editing decisions.
  
• Research coding questions and issues.
  
• Provide expert testimony in state fair hearings and to leadership of health plans when discussing state complaints from providers.
  
• Triage and resolve escalated health plan, Claims department, and provider inquires and/or issues.
  
• Responsible for communication across IT, health plans, vendors, and all other affected departments.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

Associate’s degree in Medical Billing and Coding, Healthcare, related field, or equivalent experience. 5+ years of account management, nursing, healthcare management, medical billing, or CPT coding, claims, coding analysis and trends, and/or data management experience. Experience using code editing software systems in a managed care organization preferred.

Licenses/Certifications:

Current state’s RN license or Certified Professional Coder (CPC) preferred.

Pay Range: $70,100.00 - $126,200.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act