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You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose:Perform quality reviews to ensure high level of customer service and/or accuracy in processing claims and transactions
Conduct procedural and quality reviews/audits to ensure adherence to policies and procedures and high levels of customer service, satisfaction and accuracy using applicable tools and technologies
Provide written documentation to management regarding quality review/audit results
Collaborate with various cross functional departments to identify training needs, system errors, processing errors, etc. and develop work plans and processes
Participate in continuous quality improvement initiatives and serve as a resource to others regarding quality concerns
Analyze data to ensure adjustments/changes yielded anticipated results
Asist with managing databases, policies and procedures related to assigned areas
Complete special projects as needed
10% travel may be required
Our Comprehensive Benefits Package:Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
Education/Experience:High School Diploma or equivalent. 4+ of combined call center/customer service and training/auditing/data analysis experience. Knowledge of insurance or healthcare products and procedures highly preferred. Depending on the state, bi-lingual skills may be 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.TITLE: Quality Specialist I- Appeals/Claims Audit- Remote Nationwide AvailableLOCATION: Clayton, MissouriREQNUMBER: 1272759
