Medical Coding Reviewer I

About This Role The Medical Coding Reviewer I position involves performing clinical and coding medical claim reviews to ensure compliance with coding practices. This role is ideal for individuals with a background in medical billing and coding who are detail-oriented and analytical. Highlights Location: Remote, MO Schedule: Full Time, Day shift What You'll Do Analyze provider billing practices using code auditing software and regulatory codes Review medical records for consistency with billing for appeals and adjustments Collaborate with the Medical Director to validate decisions and create medical policy Assist with research of health plan coding questions Identify potential billing errors, abuse, and fraud Flag cases for potential prepayment review Maintain appropriate records and documentation Perform other duties as assigned Comply with all policies and standards Requirements Education Associate's degree in related field or equivalent experience Experience 2+ years of experience in medical billing & coding, coding/data analysis, or related clinical experience Licenses & Certifications One of the following licenses required: LPN, RN, CPC, CPC-H, CPC-P, CPC-A, CCS, CCS-P, RHIT, RHIA, CPMA, or Paramedic Benefits Competitive pay Health insurance 401K and stock purchase plans Tuition reimbursement Paid time off plus holidays Flexible work schedules (remote, hybrid, field, or office) About Centene Centene is a leading healthcare provider committed to delivering exceptional patient care. They connect people to the care they need to live healthier lives, supporting individuals, families, and communities through meaningful work. #J-18808-Ljbffr Centene