Been in my role almost 13 years. Now suddenly, I’m marked off on audits for the most ridiculous reasons. I can’t argue/ rebuttal it because I was told I’m not allowed to per mgmt. The auditor is incorrect in some of their “findings”. I feel like this is a set up.
Never been written up, never failed audits and now I can’t do anything right??? But “it’s to help you improve” . BS
16 replies (most recent on top)
True. I received an audit today for not applying an informational code that isn't even in the workflow. The platform will not allow me to rebut and forces you to accept the error. Now normally I would allow for the possibility of a system glitch etc - but not anymore. Not only is the audit for an informational code petty but it frigin' ridiculous and a waste of everyone's time. AND how come these auditors can't read a workflow? How do you audit something you haven't ever worked or learned to work? So done with this place.
Centene is a shady company and leadership is totally sketch. I worked for the company for 15 years, always excelled and never once was written up for anything. Randomly I was placed on a PIP with total bogus claims. I met all requirements of the PIP to absolute perfection for 3 months until the day I received a call from HR stating my position was eliminated. They offered me 2 weeks severance for 15 years on the job. Absolutely horrendous. I told them to keep their chump change and f*ck off during the call.
Understood that you are not comfortable discussing more detail if management is here. It was my understanding with audits is that a rebuttal is always allowed. You may not be right on the rebuttal but any audit fail should be reviewed if the person who is failing feels like they did follow the work process and can prove they did every step as outlined. Management should not take a “no rebuttal allowed” approach unless without a doubt you have missed a step in a documented work process in which case the fail is on your part. If you followed the process - show them where what you did was right. Show where the process doesn’t cover the scenario you encountered and why you did what you did on the item you were working.
Rebuttals can and should (if you’re doing the process as written) lead to work process updates for new scenarios encountered.
Since I was informed there are management ppl on these threads responding to posts, I decline to be anymore detailed. However the process and way we do things and how we document has not changed , and ppl have been doing their work the same way all along, and now multiple ppl are getting errors for specific things that we never have before . One person on another team was put on a PIP for “inconsistent work”
And has been here longer than me , also with no write ups ever . No coachings , nothing . It is up to the PL if a rebuttal will be allowed or not . Auditors are not always correct and they do not get audited themselves . The math isn’t mathing.
You should always be allowed at least one rebuttal.
What are some of the reasons you’re getting dinged on audit for, OP? Be as vague as you’d like but at least give us SOME kind of context.
Your number of years with the company isn’t relevant to your complaint.
This happened to me when a former sup didn’t like me.
As soon as I was under other people, I was suddenly able to dispute, and I was audited way less.
Once he left my metrics were phenomenal, I was recognized for the work I was doing, and even helped with a lot of process improvement.
It’s the company, not you.
Apply and move on.
You’ll be better for it.
To those pointing fingers back I would ask very directly how is one to know if they aren’t allowed to submit a rebuttal if the audits are in fact correct or oversight? At least if she had the opportunity to rebut they would be required to send the rationale for the change or issues. That is where the learning comes if the standards changed.
op give more context. No one gets marked off on audits for “ridiculous reasons”
You clearly have become complacent at errors and that is audits fault? If you’re getting marked off on audits you are doing something that is causing problems and affects the members or other departments.
A lot going on here, but overall the scrutiny of everything (during a time of layoffs) is critical. You have to bring your game every single day or find another job. You spoke a lot of "what they did", but you've not mention anything of "what you/I did". Can you give us some context and point the finger back at yourself for a moment?
Everyone seems stressed overwhelmed. The vibe is different to the point dread coming to work. Rarely anything you do seems good enough. I feel like at any moment there will be layoffs.
If you are a claims analyst availability is the amount of time you are in a claim and it is timed by the system. You have to be in claims processing for a min of 6.5 hours a day total. The remaining 1.5 of your 8 hrs is used for side chairs, meetings etc and if you go past that it counts against your "availability". Even if those things are required of you it's counted against your time. Completely set up to micromanage and set you up to fail.
I’m curious what “availability” means and what the justification was.
This is why I keep a spreadsheet of everything I do because once the report was wrong and I didn’t have any proof but the next time I did!!
If your job gets a bonus, it’s also an easy way to ensure you don’t qualify for a bonus.
Same here. 7 years never had an audit that wasn't overturned and never on a PIP always 100% quality & financial & exceeded prod. I am on my second since June 2024 - one for "availability" and now for availability & production. They have changed the metrics purposely and expect us to pick up the slack for all the people on our team they let go. It is to set us up for failure. My 1st I got 2 months. This current PIP is 30 days. They are looking for reason to fire us to try to get around severance and unemployment. I have no respect for this company on any level anymore.
it’s usually a set up, they want to due layoffs. most people do not survive PIP, search on YouTube what your options are regarding PIP, job market is rough. You can try to stick it out, but I would start looking at options.