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Job Description
- Req#: 1476728
- Validate provider, vendor, and internal diagnosis coding for accuracy by reviewing and analyzing samples of coding and claims extract compared to actual medical records.
- Review and identify trends in coding discrepancies and notify applicable department for potential training and education.
- Determine coding issues and discrepancies and make updates as necessary.
- Identify issues, determine impact to risk adjustment models and reports results for various products and services.
- Coordinate delete files with leadership from Medicaid, Medicare, and Marketplace and Encounters department.
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.
Position Purpose: Audit vendor and internal risk adjustments coding to ensure accuracy and identify and mitigate any risks.
Licenses/Certifications: CPC, CPC-H, CPC-P, CCS, CCS-P, RHIT, RHIA or CPMA required.
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.About the company
Centene Corporation is a publicly traded managed care company based in St.
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