Authorization Specialist I
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Job Description
Authorization Specialist supporting Centene’s healthcare prior authorization and utilization management processes. Documenting medical information, tracking referrals, and maintaining authorization records.
Responsibilities:
- Support prior authorization requests to ensure they are properly addressed within contractual timelines
- Assist the utilization management team with documenting authorization requests
- Obtain accurate and timely documentation for services related to members' healthcare eligibility and access
- Support authorization requests in accordance with the insurance prior authorization list
- Perform data entry to maintain and update authorization requests in the utilization management system
- Track authorizations and referrals and maintain appropriate documentation according to policies and guidelines
- Document medical information such as history, diagnosis, and prognosis for clinical reviewer determination
- Stay current on healthcare, authorization processes, policies, and procedures
- Perform other duties as assigned
Requirements:
- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
- High School diploma or GED required
- Understanding of medical terminology preferred
- Understanding of insurance preferred
- Entry-level position typically requiring little or no previous experience
- Compliance with all policies and standards
Benefits:
- Competitive pay
- Health insurance
- 401K plan
- Stock purchase plan
- Tuition reimbursement
- Paid time off
- Paid holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
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