Member Risk Adjustment Coordinator II

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement.

• Assist members with scheduling office visits with primary care provider.
• Participate in outreach calling campaigns.
• Retrieves charts from electronic medical record systems and compile medical records to send to other parties for coding.
• Requests medical records by making outbound phone calls to provider groups.
• Completes supplemental medical records requests using Excel files.
• Assist with providing updated member and provider information to vendors.
• Directs medical record requests to the responsible party.
• Resolves outstanding vendor pending request within a timely manner.
• Conduct member outreach, including member correspondence and information on strengthening communication between members and providers.
• Ensure follow up on member appointments or other tasks designated.
• Assist with resolving technical issues related to data reporting issues.
• Assist with ad hoc requests.

Education/Experience: High school diploma or equivalent. 2+ years of customer service or medical office experience. Experience with medical record retrieval systems preferred. Billing or coding experience preferred. Intermediate Excel skills preferred. Critical thinking skills needed.

Pay Range: $22.79 - $38.84 per hour

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.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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