Authorization Specialist I

Centene

115d • $16 - $22 • Remote

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This is a remote role with a M-F 8 shift starting between the hours of 6am - 9 am.

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.

Responsibilities

• 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.
• 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.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED