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Process Analyst

Company: Centene
Location: Austin
Posted on: February 15, 2020

Job Description:

Process Analyst Transforming the health of the community, one person at a time Who We Are Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well. What's it like to work for Centene? Bringing our Purpose to Life: Working at Centene & list=PLrbAom5gY6_q3Qugxz2LEhRlzMfcs6I7r & index=19 Subsidiaries Health Plans: Serving Members and Their Communities Caring for our members, and the communities they call home, means being where they are. Centene's unwavering commitment to a local approach is demonstrated every day by its state-based health plans. Our experience in healthcare began as a single Medicaid health plan in Wisconsin that now stretches from coast to coast and beyond. We offer a full range of high-quality commercial and government-sponsored healthcare programs. Even as we expand, we are able to remain attentive to the unique needs of the communities we serve by building a local presence in each of our markets from the ground up. Working hand in hand with local healthcare providers and other groups that share our dedication, our employees help members access care, coordinate referrals to health and social services, and address concerns and questions. Careers at Centene Position Purpose: Perform day to day duties to support the functions of claims processing (check run), configuration request submission, user acceptance testing, encounter accuracy, authorizations, benefit and pricing accuracy, contract negotiation process, and systems and claims analysis and reporting. - Initiate setup, submit configuration requests and perform user acceptance testing (UAT) for provider specific negotiated contracts or pricing errors - Investigate, analyze, and review claims and EDI data. Identify and resolve issues - Review state documentation to identify any program changes. Assist with system updates and communication of changes to stakeholders - Audit provider setup and submit corrections - Facilitate meetings with provider relations and clinical staff - Assist in identifying methods to reduce the volume of pended and adjusted claims and recommend solutions to increase auto-adjudication rates Education/Experience: Bachelor's degree in related field or equivalent experience. 1+ years of data analysis experience, preferably a healthcare related industry. Familiarity with claims processing preferred. This position will be supporting a Federal government contract, therefore it requires U. S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 or higher security. 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. Medical Management USA-Texas-Austin Corporate Full-time

Keywords: Centene, Austin , Process Analyst, Professions , Austin, Texas

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