Supervisor, Payment Integrity – Appeals & Disputes

Centene Corporation

. Lead clinical coding compliance nurses and non-clinical team members through the code editing adjudication process .

Posted 9/30/2026full-timeRemote • United StatesMid-LevelSenior💰 $70,100 - $126,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical coding compliance, overseeing code editing processes, and managing relationships with health plans and departments. Proficient in coding analytics, operational efficiencies, and providing expert testimony in healthcare settings.

Highest-signal resume keywords

Clinical Coding ComplianceCPT CodingAccount ManagementCode Editing Software SystemsCertified Professional Coder (CPC)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical BillingHealthcare ManagementCoding AnalysisData ManagementQuality Audits

Soft Skills

CommunicationProblem-SolvingLeadership

Tools & Technologies

Code Editing Software Systems

Certifications & Qualifications

Registered Nurse (RN) LicenseCertified Professional Coder (CPC)

Industry Keywords

Managed Care OrganizationComplianceClaims DepartmentHealth PlansOperational Efficiencies

About the role

Key responsibilities & impact

Lead clinical coding compliance nurses and non-clinical team members through the code editing adjudication process
Oversee prepay compliance, adjustments, and appeals for multiple code editing software systems
Ensure the Coding Analytics team meets production standards and passes quality audits
Oversee relationships with health plans, Claims, and other departments
Identify and implement best practices and operational efficiencies
Serve as a health plan account liaison and provide expertise on code editing decisions
Research coding questions and issues
Provide expert testimony in state fair hearings and to health plan leadership regarding state complaints from providers
Triage and resolve escalated health plan, Claims department, and provider inquiries or issues
Coordinate communication across IT, health plans, vendors, and affected departments
Perform other duties as assigned

Requirements

What you’ll need

Associate’s degree in Medical Billing and Coding, Healthcare, related field, or equivalent experience
5+ years of account management, nursing, healthcare management, medical billing, CPT coding, claims, coding analysis and trends, and/or data management experience
Experience using code editing software systems in a managed care organization preferred
Current state’s RN license or Certified Professional Coder (CPC) preferred
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