[Hiring] Authorization Specialist I @Centene Corporation

Role Description

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

Qualifications

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

Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
• This position is scheduled for 37.5 hours per week
• Optional overtime opportunities may be available based on business needs
• Work Location: Fully remote
• Workdays: Monday, Tuesday, Friday, Saturday, and Sunday
• Weekday Hours: 8:30 a.m.–5:00 p.m. EST
• Weekend Hours: 10:00 a.m.–6:00 p.m. EST
• Days Off: Wednesday and Thursday

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