• Supervisor, Payment Integrity

    Centene Corporation (Jefferson City, MO)
    …and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid Services. + Ensures Payment Integrity DRG Review ... with coding practices through a comprehensive review and analysis of medical claims , medical records, claims history, state regulations, contractual obligations,… more
    Centene Corporation (09/27/25)
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  • Code Edit Disputes Medical Coder

    Humana (Jefferson City, MO)
    …Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The ... Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention to detail… more
    Humana (11/14/25)
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  • Sr. Provider Reimbursement Professional Certified…

    Humana (Jefferson City, MO)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS +… more
    Humana (11/21/25)
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