Authorization Specialist I

Centene Corporation•Remote-NY, NY

1d•$16 - $23•Hybrid

About The Position

Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access. Must be flexible to work weekend hours.

Requirements

Requires a High School diploma or GED.
Entry-level position typically requiring little or no previous experience.
Understanding of medical terminology and insurance preferred.
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.

Responsibilities

Supports authorization requests for services in accordance with the insurance prior authorization list
Supports and performs data entry to maintain and update authorization requests into utilization management system
Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines
Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
Remains up-to-date on healthcare, authorization processes, policies and procedures
Performs other duties as assigned
Complies with all policies and standards