Business Analyst II – Coding

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $56.2k - $101k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Business Analyst

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Perform various analysis and interpretation to link business needs and objectives for assigned function • Responsible for payment integrity repository updates and ensuring it remains up to date and accurate • Review, analyze, and interpret coding, reimbursement, and regulatory guidelines to ensure organizational compliance and payment integrity • Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic to support accurate claims adjudication • Monitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation • Identify ways to enhance performance management and operational reports related to new business implementation processes • Develop and incorporate organizational best practices into business applications • Lead problem solving and coordination efforts between various business units • Assist with formulating and updating departmental policies and procedures • Performs other duties as assigned • Complies with all policies and standards

🎯 Requirements

• Bachelor’s degree in related field or equivalent experience • 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience • Knowledge of managed care information systems and experience in benefits, pricing, contracting or claims preferred • Knowledge of provider reimbursement methodologies preferred • Previous structured testing experience preferred • Coding certification such as a CPC or similar preferred • Claims coding research experience preferred • Excel skills with pivot tables and VLOOKUPs preferred • Smartsheet experience preferred • Must be authorized to work in the U.S. without the need for employment-based visa sponsorship

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules