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Payment Integrity Analyst II
Centene Corporation. Perform analysis and interpretation to link business needs and objectives for the assigned function .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong analytical skills and the ability to link business needs with objectives, while effectively managing user requirements and improving processes. Proficient in data analysis, user acceptance testing, and compliance with policies in a healthcare or claims payment context.
Highest-signal resume keywords
Business Process AnalysisHealthcare Claims AuditingMedical Coding CertificationProficiency in ExcelUser Acceptance Testing
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data AnalysisRoot Cause AnalysisDocumentation of Business ProcessesImplementation of Business SolutionsPerformance Management Reporting
Soft Skills
Problem-SolvingCoordination Between Business Units
Tools & Technologies
Ticketing SystemsManaged Care Information Systems
Certifications & Qualifications
Medical Coding Certification
Industry Keywords
Payment IntegrityClaims PaymentProvider Reimbursement MethodologiesBenefitsPricingContracting
About the role
Key responsibilities & impact- Perform analysis and interpretation to link business needs and objectives for the assigned function
- Support business initiatives through data analysis
- Identify implementation barriers and conduct user acceptance testing of new systems
- Identify and analyze user requirements, procedures and problems to improve existing processes
- Perform detailed analysis on assigned projects
- Recommend potential 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 efforts 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
What you’ll need- Bachelor’s degree in related field or equivalent experience
- 2+ years of business process analysis, preferably healthcare, or claims payment/analysis experience
- Experience in Payment Integrity and healthcare claims auditing preferred
- Medical coding certification preferred
- Strong analytical and root cause analysis skills preferred
- Proficiency in Excel preferred
- Experience working with ticketing systems preferred
- 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
- Ability to document business processes and gather requirements
- Compliance with all policies and standards
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