Prior Authorization Specialist II - Remote/Hybrid in MO

Centene Management Company LLC; Missouri; Hybrid; USD 25,000 - 39,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Job summary

Centene Management Company LLC in Missouri seeks a Prior Authorization Support specialist to assist the utilization management team, ensuring timely and accurate documentation for authorization requests.

The role requires a high school diploma/GED with 1-2 years of related experience, knowledge of medical terminology and insurance, and the ability to verify coverage and maintain records in the authorization system.

Qualifications

• Requires knowledge of medical terminology and insurance practices.
• Experience or familiarity with utilization management processes is preferred.
• Ability to document and research medical information for authorization decisions.

Responsibilities

• Assist utilization management team with authorization requests and documentation.
• Research and record necessary medical information (history, diagnosis, prognosis) for clinical review.
• Verify member insurance coverage and service eligibility via system tools.
• Enter and maintain authorization requests in the utilization management system and route to clinical reviewers.

Skills

Medical terminology

Insurance knowledge

Education

High School diploma/GED

Job description

Centene Management Company LLC in Missouri seeks a Prior Authorization Support specialist to assist the utilization management team, ensuring timely and accurate documentation for authorization requests.

The role requires a high school diploma/GED with 1-2 years of related experience, knowledge of medical terminology and insurance, and the ability to verify coverage and maintain records in the authorization system.