Authorization Specialist I

Meridian of Illinois; Illinois; Hybrid; USD 23,000 - 32,000; Full time

Job summary

Centene is seeking an entry-level Prior Authorization Support role in Illinois to assist the utilization management team with authorization requests and related documentation. The position emphasizes accurate data entry, knowledge of medical terminology and insurance processes, and adherence to policies.

Responsibilities include maintaining authorization records, assisting with tracking, and supporting the clinical reviewer with necessary medical information.

Qualifications

• Requires a High School diploma or GED; entry-level position with minimal prior experience.
• Understanding of medical terminology and insurance preferred.

Responsibilities

• Supports authorization requests for services in accordance with the insurance prior authorization list.
• Performs data entry to maintain and update authorization requests in the utilization management system.
• Assists utilization management team with tracking and documentation on authorizations and referrals.
• Contributes to the authorization review process by documenting medical information for clinical reviewer assessment.
• Keeps up-to-date on healthcare, authorization processes, policies and procedures.
• Performs other duties as assigned and complies with policies and standards.

Skills

Data entry

Medical terminology

Insurance knowledge

Communication skills

Education

High School diploma or GED

Tools

Utilization management system

Job description

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.

Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

• 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: $16.35 - $23.46 per hour

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

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