Authorization Specialist

1 day ago

Tallahassee FL USA, United States Centene Corporation Full time
Job Summary

Centene Corporation is seeking a highly skilled Authorization Specialist to join our Medical Management/Health Services team. As a key member of our team, you will play a critical role in supporting the prior authorization process, ensuring timely and accurate documentation of authorization requests, and maintaining compliance with contractual timelines.

Key Responsibilities:
  • Supports the prior authorization request process to ensure all requests are addressed properly and within contractual timelines.
  • Aids the utilization management team in documenting authorization requests and obtaining accurate and timely documentation for services related to member healthcare eligibility and access.
  • Supports and performs data entry to maintain and update authorization requests into the utilization management system.
  • Assists the 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:
  • Requires a High School diploma or GED.
  • Entry-level position typically requiring little or no previous experience.
  • Understanding of medical terminology and insurance preferred.
What We Offer:
  • 100% remote position.
  • Competitive pay rate of $22.54 per hour.
  • A comprehensive benefits package, including health insurance, 401K, and stock purchase plans.
  • Tuition reimbursement and paid time off plus holidays.
  • A flexible approach to work with remote, hybrid, field, or office work schedules.

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