Senior Medical Coding Reviewer
18 hours ago
Join Centene Corporation, a leading healthcare company, as a Senior Medical Coding Reviewer. In this role, you will play a critical part in ensuring the accuracy and compliance of medical coding practices across our organization.
Key Responsibilities:- Perform medical claim reviews to ensure compliance with coding guidelines and regulations.
- Develop and maintain review guidelines for corporate medical coding reviews.
- Lead team of expert witnesses defending Centene's payment decisions in state fair hearings and health plan provider calls.
- Provide coding/clinical decisions on first-time claims, adjustments, and appeals in accordance with correct coding guidelines and Centene payment policies.
- Associate's Degree in Nursing or related field required.
- 4+ years of medical coding experience required.
- Experience in provider education, medical record auditing, and in a managed care organization preferred.
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required or LPN - Licensed Practical Nurse - State Licensure required or CPC, CPC-H, CPC-P, or CPC-A required or CCS or CCS-P required or RHIT or RHIA required or PARAMEDIC - Paramedic – Licensed required or CPMA required or Medical Record Technician (MRT) required.
- Competitive pay: $32.41 - $58.31 per hour.
- Comprehensive benefits package, including health insurance, 401K, and stock purchase plans.
- Tuition reimbursement and paid time off plus holidays.
- Flexible approach to work with remote, hybrid, field, or office work schedules.
Centene Corporation is an equal opportunity employer 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.
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