Authorization Specialist I

Centene
$16 - $22 an hour
New York, New York
Full time
2 days ago

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.

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.
  • 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

Education/Experience: Requires a High School diploma or GED.
Entry-level position typically requiring little or no previous experience.

Understanding of medical terminology and insurance preferred.

Pay Range: $16.01 - $22.98 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. 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 may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply
Other Job Recommendations:

Clinical Review Nurse - Prior Authorization

Centene
Los Angeles County, California
$26 - $47 an hour
  • Performs medical necessity and clinical reviews of...
  • Works with healthcare providers and authorization team to...
1 week ago

Authorization Specialist II

Health Net
California
$17 - $27 an hour
  • Supports the authorization review process by researching...
  • Verifies member insurance coverage and/or service/benefit...
1 week ago

Pre-Authorization Specialist

Cognizant Technology Solutions
Minot, North Dakota
This is a remote position open to any qualified applicant in the United States. The hourly rate for this position is $18 per hour,...
1 week ago

Authorization Specialist

Prestige Pulmonary Consultants, Inc.
Los Angeles County, California
$22 - $26 an hour
  • Review and process authorization requests for medical...
  • Verify patient insurance coverage and eligibility for...
1 week ago

Insurance Authorization Representative

AdventHealth Medical Group West FL
Tampa, Florida
$15 - $25 an hour
All the benefits and perks you need for you and your family : The community you'll be caring for : AdventHealth Medical Group West...
2 days ago

Centralized Authorization Coordinator

LHC Group
Capitol Planning Region, Connecticut
$59,933 - $75,889 a year
  • Monitors documentation of specified details related to the...
  • Ensures additional pre-certification is obtained as needed...
3 days ago

Office Visit Authorization Coordinator Bilingual

The Oncology Institute of Hope and Innovation
Los Angeles County, California
Founded in 2007, The Oncology Institute of Hope and Innovation (TOI) is advancing oncology by delivering highly specialized,...
3 weeks ago