Claims Examiner I-Ops

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.

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

***Remote Role. Highly preferred that candidate resides in the state of CA. Candidates that reside in/or around Los Angeles may occasionally report to the local office. Seeking a candidate with a Pharmacy Tech background.***

Position Purpose: Review claims for adjudication, adjustment, billing, coding, compliance and reimbursement

• Review, process and resolve pending medical, hospital and prescription claims
• Maintain appropriate records, files, documentation, etc.
• Enter manual claims into claims system
• Work mandatory overtime as needed

Education/Experience: High school diploma or equivalent. 0-2 years of claim processing or medical billing experience in a managed care environment or physician’s office.Pay Range: $15.87 - $27.25 per hour

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

Originally posted on Himalayas