✨ About The Role
- The role involves overseeing daily functions of the production team within the Payment Integrity team
- Responsibilities include ensuring the Coding Analytics team consistently meets production standards and passes quality audits
- The position requires overseeing relationships with health plans, claims, and other departments to impact Centene's key performance indicators
- The job involves identifying and implementing best practices and operational efficiencies
- The role also includes serving as a health plan account liaison, researching coding questions, and providing expert testimony in state fair hearings and to leadership of health plans
âš¡ Requirements
- Ideal candidate will have at least 5 years of experience in account management, nursing, healthcare management, medical billing, or CPT coding
- Strong background in claims, coding analysis, and trends, as well as data management
- Experience using code editing software systems in a managed care organization is preferred
- Ability to provide expert testimony in state fair hearings and to leadership of health plans
- Excellent communication skills to triage and resolve escalated health plan, claims department, and provider inquiries