You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

　　Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

　　Gather, analyze and report verbal and written member and provider complaints, grievances and appeals

　　Prepare response letters for member and provider complaints, grievances and appeals

　　Maintain files on individual appeals and grievances

　　May coordinate the Grievance and Appeals Committee

　　Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information

　　Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.

　　Manage large volumes of documents including copying, faxing and scanning incoming mail

　　Education/Experience: High school diploma or equivalent. Associate’s degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem solving skills.Pay Range: $18.27 - $31.10 per hour

　　Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

　　Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.