Remote Authorization Specialist II – Utilization

Centene Corporation; United States; Remote; USD 25,000 - 39,000; Full time

Job summary

Centene Corporation is seeking a dedicated professional to support the prior authorization request process and assist the utilization management team in Florida. The role ensures timely authorization determinations, documents medical information, and verifies insurance coverage to facilitate payment authorization.

The candidate should have a high school diploma or GED with 1-2 years of related experience. The position offers hourly pay and comprehensive benefits in a full-time role, with varied

Qualifications

• Requires a High School diploma or GED.
• Requires 1-2 years of related experience.
• Knowledge of medical terminology and insurance preferred.

Responsibilities

• Aids the utilization management team and maintains tracking on authorizations and referrals.
• Supports authorization review by researching medical information for clinical determination.
• Verifies member insurance coverage and aligns authorization with guidelines for timely adjudication.
• Performs data entry to update authorization requests in the utilization management system.
• Supports and processes authorization requests per the prior authorization list and routes to reviewer.
• Stays up-to-date on healthcare, authorization processes, policies and procedures.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Medical terminology

Insurance knowledge

Education

High School diploma or GED

Job description

Centene Corporation is seeking a dedicated professional to support the prior authorization request process and assist the utilization management team in Florida. The role ensures timely authorization determinations, documents medical information, and verifies insurance coverage to facilitate payment authorization.

The candidate should have a high school diploma or GED with 1-2 years of related experience. The position offers hourly pay and comprehensive benefits in a full-time role, with varied