Authorization Specialist I

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. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.

Position Purpose

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.

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

Requirements

• 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

Schedule

Friday-Tuesday 8:30am-5:00pm EST

Pay

Pay Range: $16.35 - $23.46 per hour. 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

• 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

Benefits may be subject to program eligibility.