Risk Adjustment Specialist – Non-Clinical

Job not on LinkedIn

🔥 0 minutes ago

🤠 Texas, Washington – Remote

🤠 Texas – Remote ☕ Washington – Remote

💵 $23 - $39 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🎲 Risk

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Engage and educate providers on accurate capture and reporting of chronic conditions for revenue management • Ensure programs follow state and federal guidelines • Engage, train, and provide monthly reporting for 60–100 providers • Use data to develop strategies and best practices that help providers earn incentives and increase company revenue • Ensure medical records are received and work with vendors to overcome barriers • Ensure providers comply with mandated audits and medical record requests • Conduct outreach through phone, email, and Zoom meetings • Serve as point of contact for provider questions, reports, and issues throughout projects • Use Excel and internal tools to develop engagement, issue, and progress reporting • Review and analyze project data to identify barriers and develop provider-success strategies • Use vendor portals to identify barriers to receiving medical records for risk adjustment • Research provider information using internal systems and the internet • Outreach to provider offices and share best practices to obtain medical records for coding and abstraction

🎯 Requirements

• Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future • High School Diploma / GED • 2 years of Health Insurance, Customer Service, Claims, or Provider Office experience required • Health Insurance experience preferred • 10% in-state travel required • Experience with provider engagement, training, data analysis, and reporting • Proficiency with Excel and internal tools • Ability to use vendor portals, internal systems, and internet research • Professional oral and written communication skills • Ability to conduct outreach by phone, email, and Zoom meetings

🏖️ Benefits

• Competitive pay • Health insurance • 401K plans • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity