{"id":2054795,"url":"https://alion.io/job/centene-corporation-coding-quality-specialist","title":"Coding Quality Specialist","company":{"id":647,"name":"Centene Corporation","domain":"centene.com","url":"https://alion.io/company/centene-corporation","size_band":"201-500","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":100,"open_postings":17,"ghost_share":0,"stale_share":0.118,"repost_share":0,"time_to_fill_p50_days":4,"computed_at":"2026-10-14T06:34:16Z"}},"role":"Administrative","role_family":"Administrative","seniority":"junior","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"posting_text","remote_working_hours":null,"hiring_geo_confidence":"explicit","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":56200,"max":101000,"currency":"USD","period":"year","gross":null,"usd_annual":101000},"salary_estimate":null,"experience_years_min":2,"visa_sponsorship":true,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-10-07T23:20:13Z","employer_posted_date":"2026-10-07","last_verified_at":"2026-10-14T07:22:48Z","board_verified":true,"closed_at":null,"days_open":6,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":6},"description":"Position Purpose: The Coding Quality Coordinator II is the journey level position within a job series that performs complex reviews of clinical documentation on inpatient and outpatient medical records. Validates accuracy of diagnostic and procedural coding, payment methodology, and reimbursement amount; develops written rationale of findings; responds to providers for resolution of appeals.\nKey Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.\nPerforms complex review of physician clinical documentation on inpatient and outpatient medical records.\nPerforms quality analysis to determine accuracy of diagnostic and procedural coding, the correct interpretation and application of official coding guidelines and rules, and assignment of appropriate codes.\nDetermines correct payment methodology and reimbursement.\nDevelops case-specific written rationale to substantiate and communicate findings to hospital, provider, medical director, and peer review team.\nConducts coding re-review for decisions that are based on coding convention and sequencing guidelines, not requiring medical review.\nIdentifies clinical questions and refers cases to Medical Director.\nResponds to providers for resolution of appeals.\nReviews updates to Coding Clinics, coding newsletters, and other professional resources to maintain up-to-date knowledge.\nParticipates in ongoing in-service programs for coding-related or clinical education.\nIdentifies and interprets patterns of possible fraud or abuse and refers to appropriate party for further evaluation and corrective action.\nConducts periodic peer reviews.\nOther duties as assigned.\nPerforms other duties as assigned.\nComplies with all policies and standards.\nEducation/Experience: AA, Health Information Technology, preferred. Two years experience with Diagnosis Related Groups (DRG), ICD-9-CM/ ICD-10-CM/PCS, CPT, HCPCS coding.License/Certification: One or more of the following certifications may be required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC)Pay Range: $56,200.00 - $101,000.00 per year\nAt Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.\nCentene 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.\nCentene 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.\nQualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act","description_format":"text","description_chars":3926,"description_truncated":false,"requirements":{"experience_years_min":2,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["401k plan","Health insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-10-07T23:20:13Z"}],"visa":[],"liveness":{"score":31,"band":"fade","label":"Fading","p_open":1,"p_active":0.689,"p_room":0.45,"age_days":6,"expected_fill_days":4,"reasons":["conf:5","velocity","win:tail","comp:junior,brand"],"computed_at":"2026-10-14T06:34:16Z"},"pay":{"stated_usd_annual":101000,"is_top_pay":true},"html_url":"https://alion.io/job/centene-corporation-coding-quality-specialist","json_url":"https://alion.io/job/centene-corporation-coding-quality-specialist.json","meta":{"generated_at":"2026-10-14T10:29:24Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":12264,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-15T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":647},"rest":"https://alion.io/mcp/rest/get_company?id=647"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fcentene-corporation-coding-quality-specialist"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fcentene-corporation-coding-quality-specialist"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fcentene-corporation-coding-quality-specialist"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/centene-corporation-coding-quality-specialist\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fcentene-corporation-coding-quality-specialist"}]}