Business Analyst II – Repository Updates

🔥 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

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

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 analysis and interpretation to link business needs and objectives for the assigned function • Maintain payment integrity repository updates and ensure accuracy • Review coding, reimbursement, and regulatory guidelines for organizational compliance and payment integrity • Develop, implement, and maintain payment policies, reimbursement methodologies, and claims editing logic • Monitor, report on, and track regulatory, coding, and policy updates • Ensure timely implementation and communication of changes to impacted stakeholders • Support business initiatives through data analysis, implementation-barrier identification, and user acceptance testing • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed project analysis, recommend business solutions, and assist with implementation • 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 between various business units • Assist with formulating and updating departmental policies and procedures • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

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

🏖️ 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