Authorization Specialist I – Medicare

Job not on LinkedIn

🔥 23 minutes ago

🗽 New York – Remote

🗽 New York – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Support prior authorization requests to ensure they are addressed properly and within contractual timelines • Aid the utilization management team in 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 • Assist with tracking and documentation of authorizations and referrals according to policies and guidelines • Document medical information such as history, diagnosis, and prognosis for clinical reviewer determination • Stay up-to-date 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 • Medicare experience preferred • High School diploma or GED required • Understanding of medical terminology and insurance preferred • Entry-level position typically requiring little or no previous experience • Ability to comply with all policies and standards

🏖️ Benefits

• competitive pay • health insurance • 401K • stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules • additional forms of incentives may be included in total compensation