Coding Business Analyst II – Policy Review

🔥 0 minutes ago

🌵 Arizona, Florida, +2 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🚗 Michigan – 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 • Detailed reviews of both state specific and corporate Payment policies for Compliance and Governance • Review, analyze, and interpret coding, reimbursement, and regulatory guidelines • Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic • Monitor, report on, and track regulatory, coding, and policy updates • Support business initiatives through data analysis 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 and recommend business solutions

🎯 Requirements

• Bachelor’s degree in related field or equivalent experience • 2+ years of business process analysis, preferably healthcare • Knowledge of managed care information systems and 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 • Excel skills with pivot tables and VLOOKUPs

🏖️ Benefits

• 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