Hiring Now: Authorization Specialist II

Remote Full-time
Quick Overview:Start Date: Immediate openings availableLocation: RemoteCompensation: a competitive salaryPosition: Authorization Specialist IICompany: Workwarp  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.
• *Candidate must reside in Oregon, Washington or Nevada. Candidate must be willing to work evenings, weekends and/or holidays.**

Position Purpose: Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.
• Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines
• Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
• Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment
• Performs data entry to maintain and update various authorization requests into utilization management system
• Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer
• 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
Requires 1 – 2 years of related experience

Knowledge of medical terminology and insurance preferred.Pay Range: $17.50 - $27.50 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. Total compensation may also include additional forms of incentives.

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 Job! Take the Next StepAre you ready for this challenge? Apply now and let's discuss how you can become a vital part of our success story.

Apply Now
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Looking for Before and After School Instructor (Magnuson Elementary) in Seattle, WA

Remote Full-time

[PART_TIME Remote] Remote Human Resources Assistant at Cedar

Remote Full-time

ULINE- Customer Service Representative in Dallas, TX

Remote Full-time

Senior Customer Service Representative - National Remote Opportunity at blithequark: Make a Meaningful Impact While Enjoying Flexibility

Remote Full-time

Farsi to English Translators (Life Sciences – Pharmacovigilance)

Remote Full-time

**Experienced Data Entry Clerk / Typing Specialist – Remote Opportunity for a Dynamic Individual**

Remote Full-time

**Experienced Online Support Agent – Remote Customer Service Representative**

Remote Full-time

Experienced Full Time Sales Associate – Customer Service and Retail Operations Expert – The UPS Store

Remote Full-time

Experienced Full Stack Customer Service Coordinator – Remote Operations and Supply Chain Management in California

Remote Full-time

[Remote/WFM] Senior Automation Engineer

Remote Full-time
← Back to Home