Authorization Specialist

🔥 4 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $16 - $23 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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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 and obtaining accurate, timely documentation for member healthcare eligibility and access • Support authorization requests for services 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 on authorizations and referrals in accordance with policies and guidelines • Document necessary medical information, including history, diagnosis, and prognosis, for clinical reviewer determination • Remain up-to-date on healthcare, authorization processes, policies, and procedures • Perform other duties as assigned • Comply with all policies and standards

🎯 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 • Entry-level position typically requiring little or no previous experience • Understanding of medical terminology and insurance preferred

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plan • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Optional overtime opportunities may be available based on business needs

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