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Reconciliation Coordinator II

Company: Centene
Location: Little Rock
Posted on: December 4, 2019

Job Description:

Reconciliation Coordinator II Position Purpose: Responsible for the reconciliation of the error authorization reports to claims. Develop and monitor authorization errors trending and patterns by type of error. Provide trending reports to designated management for staff training purposes. - Provide technical support to staff and provide ongoing training - Operate as team lead/support for reconciliation coordinators and guide, support on daily authorizations, reports and claims - Delegate duties, , coordinate daily work, and provide training and authorization updates as they relate to reconciliation coordinators - Generate daily authorizations error report, review, correct and reconcile to pay claims - Identify trends and patterns by type of error and provide feedback for staff training purposes and/or system configuration improvement - Conduct investigation related to appropriate coding practices, diagnosis and level of care (LOC) allocation and billing by hospitals in comparison of authorized services - Investigate pended claims for authorization, conduct timely review of authorization module and reconcile for claim payment - Identify and process retrospective authorizations for services not requiring medical review - Enter notes into the claims system (CCMS) system for appropriate claims payment for single case agreements generated by Medical Director Education/Experience: High school diploma or equivalent. 4+ years of related experience working with ICD-9, CPT and HCPC codes. Working knowledge of Provider and Claim systems (MACESS, Amysis, CCMS). Claims examiner and/or claims processing experienced preferred. 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. Medical Management USA-Arkansas-Little Rock AR Marketplace Full-time

Keywords: Centene, Little Rock , Reconciliation Coordinator II, Other , Little Rock, Arkansas

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