Payment Integrity Business Analyst II

Centene Corporation

. Perform analysis and interpretation to link business needs and objectives for the assigned function .

Posted 10/2/2026full-timeRemote • United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in business process analysis and claims auditing within the healthcare sector, with a strong focus on data analysis, problem-solving, and collaboration across various business units to optimize operational performance.

Highest-signal resume keywords

Business Process AnalysisClaims Payment AnalysisPayment IntegrityMedical Coding CertificationAdvanced Proficiency in Excel

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisReimbursement ReviewCoding ValidationRoot Cause AnalysisData AnalysisUser Acceptance TestingProcess ImprovementOperational ReportingBusiness Solutions RecommendationStructured Testing

Soft Skills

CollaborationProblem-SolvingCommunicationAnalytical ThinkingCoordination

Tools & Technologies

Ticketing SystemsManaged Care Information Systems

Certifications & Qualifications

Medical Coding Certification

Industry Keywords

Healthcare ClaimsProvider Reimbursement MethodologiesBenefitsPricingContracting

About the role

Key responsibilities & impact

Perform analysis and interpretation to link business needs and objectives for the assigned function
Research, identify, validate, and document overpaid claims and recovery opportunities through claims analysis, reimbursement review, coding validation, and application of regulatory and payment policy guidelines
Monitor and analyze recovery concepts and claim outcomes throughout the review lifecycle
Collaborate with Medical Economics, Payment Integrity Operations, Claims, and BTS to investigate issues, validate results, and optimize savings performance
Support business initiatives through data analysis, identification of implementation barriers, 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, recommend 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

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Bachelor’s degree in related field or equivalent experience
2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) 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
Advanced 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

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plan
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