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Authorization Specialist II - Remote

Posted 2 weeks ago
Customer Service
Full Time
Worldwide
17.50 - 27.50/hour

Overview

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. This role acts as a resource and supports the prior authorization request process to ensure that all requests are addressed properly and in a timely manner.

In Short

  • Acts as a resource for prior authorization requests.
  • Supports the utilization management team.
  • Documents authorization requests accurately.
  • Researches necessary medical information for clinical review.
  • Verifies member insurance coverage and eligibility.
  • Maintains and updates authorization requests in the system.
  • Ensures timely adjudication for payment.
  • Remains up-to-date on healthcare policies and procedures.
  • Complies with all policies and standards.
  • Performs additional duties as assigned.

Requirements

  • High School diploma or GED required.
  • 1 – 2 years of related experience preferred.
  • Knowledge of medical terminology and insurance preferred.
  • TruCare experience strongly preferred.

Benefits

  • Competitive pay.
  • Health insurance.
  • 401K and stock purchase plans.
  • Tuition reimbursement.
  • Paid time off plus holidays.
  • Flexible work schedules including remote options.
Centene Management Company logo

Centene Management Company

Centene Management Company LLC is a diversified national organization dedicated to transforming the health of communities by providing high-quality healthcare solutions to its 28 million members. With a focus on building strong partnerships between health plans and provider networks, Centene emphasizes optimal performance in care delivery, quality improvement, and cost utilization. The company values diversity and offers a comprehensive benefits package, including competitive pay, flexible work arrangements, and support for employee development. Centene is committed to helping individuals and families live healthier lives through innovative programs and a wide range of health solutions.

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