You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

This role can be performed anywhere in the US.

Position Purpose: Analyzes, executes, and reviews bulk requests for claims automation including validating eligibility for automation, to ensure accuracy of claims data upon project completion. Reviews, investigates, adjusts/resolves claims, claims appeals, inquiries, and inaccuracies in payment of claims. Supports all internal and external customers with automation questions/issues.

Analyzes requests for eligibility for BOT/Macro automation that are received from either CCP (Cenpas Claims Projects) or direct Ad-hoc requests from the business on SharePoint.
Questions or concerns with project instructions are sent to the Claims Process Review (CPR)/Claims Liaison (CL)/or requestor.
Executes request by submitting analyzed requests to the automation tools.
Monitors and corrects identified for errors along the way.
Reviews for accuracy is completed. Identified errors are corrected.
Results, ineligible, and fallout claims are reported, and project moved to the next step of manual team or closure.
Supports internal and external customers with questions/concerns by reviewing, investigating, adjusting claims, claims appeals, inquiries, and/or inaccuracies in payment of claims projects worked.
Participates in internal upskill trainings or required Centene courses.

Education/Experience: High school diploma or equivalent. 1+ year of claims related, claim processing or medical billing experience. Working knowledge of Microsoft Office applications. Advanced Macro Express knowledge and technical background preferred. Experience using Amisys preferred. Intermediate to advanced knowledge using Excel preferred. SQL knowledge preferred.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.