Appeals Specialist II

Centene Corporation

. Support documentation and processing of appeals, disputes and reconsiderations .

Posted 10/22/2026full-timeRemote • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing appeals, disputes, and reconsiderations, with strong capabilities in data entry, documentation, and case file preparation. Proficient in tracking and reporting trends while ensuring compliance with regulatory requirements and accreditation guidelines.

Highest-signal resume keywords

Data EntryDocumentation ManagementAppeals Process KnowledgeNo Surprises Act ExperienceIndependent Dispute Resolution Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data EntryCase File PreparationResearchTrackingReporting

Soft Skills

Attention to DetailCommunication

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

AppealsDisputesReconsiderationsNo Surprises ActOpen Negotiation RequestsIndependent Dispute ResolutionHealthcare Payment DisputesRegulatory Compliance

About the role

Key responsibilities & impact

Support documentation and processing of appeals, disputes and reconsiderations
Perform data entry for tracking, logging and processing cases
Prepare correspondence and maintain documentation files
Review and investigate requests to determine applicable follow-up
Conduct research to evaluate, process and respond to cases timely
Prepare case files with supporting documentation and determinations
Gather data to track and report trends and final outcomes
Conduct outreach for status updates, determinations and explanations
Perform other duties as assigned
Comply with all policies and standards

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
High School diploma or GED required
1–2 years of related experience required
Knowledge of appeals, disputes and reconsiderations process preferred
Experience with No Surprises Act (NSA) Open Negotiation Requests (ONRs), Independent Dispute Resolution (IDR), and/or state healthcare payment disputes preferred
Ability to perform data entry, documentation, research, case-file preparation, tracking and reporting related to appeals, disputes and reconsiderations
Must comply with all policies, standards, regulatory requirements and accreditation guidelines

Benefits

Comp & perks

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