Payment Integrity Systems Specialist II

Centene Corporation

. Conduct moderately complex analysis of Payment Integrity platform outputs, claims system data, edit/rule behavior, financial/reporting outputs, and workflow performance .

Posted 10/2/2026full-timeRemote • United StatesJuniorMid-Level💰 $63,600 - $114,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Payment Integrity systems, data analytics, and financial reporting, with a strong focus on UAT, regression testing, and operational improvement initiatives. Proficient in utilizing tools like Excel, SQL, and Power BI for data validation and reporting.

Highest-signal resume keywords

Payment Integrity SystemsData AnalyticsUAT / Regression TestingFinancial ReportingPower BI

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data ValidationFinancial ReportingDashboard DevelopmentSQLExcelWorkflow TrackingQuality AssuranceOperational ControlsConfiguration SupportEdit/Rule Configuration

Soft Skills

CommunicationCollaborationProblem-SolvingGuidanceDocumentation

Tools & Technologies

ServiceNowPower BIClaims SystemsPayment Integrity PlatformsReporting Platforms

Certifications & Qualifications

LPNRNCPCCPC-HCPC-PCCSCCS-PRHITRHIACPMA

Industry Keywords

Managed Care ClaimsHealthcare Data AnalyticsOperational Financial ReportingLean Six SigmaBusiness Analysis

Tech Stack

Tools & technologies

ServiceNowSQL

About the role

Key responsibilities & impact

Conduct moderately complex analysis of Payment Integrity platform outputs, claims system data, edit/rule behavior, financial/reporting outputs, and workflow performance
Identify exceptions, trends, and operational impacts
Manage ServiceNow or similar incidents, defects, enhancement requests, and intake items
Document requirements, track status, coordinate follow-up, and escalate blockers
Coordinate UAT, regression testing, validation, and release-readiness activities for system changes
Validate defects and communicate operational impacts
Develop and maintain dashboards, trackers, recurring reports, and workstream visibility tools
Support platform enhancements, defects, metrics, savings opportunities, and operational improvement initiatives
Gather and analyze data using Excel, SQL, Power BI, financial reporting tools, or approved reporting platforms
Partner with Operations, Technology, Finance, governance/delivery, and business stakeholders
Clarify requirements, document decisions, and support transformation workstreams
Improve data quality, documentation, process consistency, and operational readiness
Provide informal guidance or onboarding support to less-experienced team members
Perform other duties as assigned and comply with policies and standards

Requirements

What you’ll need

Bachelor's degree in healthcare, business, finance, accounting, information systems, data analytics, or a related field, or equivalent experience
2+ years of relevant experience in Payment Integrity systems, managed care claims systems, data analytics, financial reporting, business analysis, platform support, quality assurance, UAT, or related technical healthcare function
Working knowledge of managed care claims, Payment Integrity concepts, system workflows, reporting, and operational controls
Experience with ticketing, UAT/testing documentation, dashboards, workflow tracking, data validation, and cross-functional issue resolution
Working proficiency with Excel and developing proficiency with SQL, Power BI, financial reporting tools, or similar data/reporting platforms
Platform Support & Governance
Data Validation & Reporting
Defect & Enhancement Intake
UAT / Regression Testing
Release Readiness
Financial Systems / Reporting
Dashboard / KPI Development
Configuration & Edit Support
Related Payment Integrity systems and technology support functions
Experience with Payment Integrity platforms, claims systems, ServiceNow, Power BI, edit/rule configuration, workflow automation, or platform modernization workstreams preferred
Working knowledge of financial systems, accounting principles, and operational financial reporting preferred
Credentials or training in Power BI, SQL, business analysis, Lean Six Sigma, healthcare data analytics, project coordination, or coding/claims concepts preferred
LPN, RN, CPC, CPC-H, CPC-P, CCS, CCS-P, RHIT, RHIA, or CPMA; RHIT, CCS, CIC, CCDS preferred

Benefits

Comp & perks

Competitive pay
Health insurance
401K and 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