Remote Prior-Authorization Specialist III

Centene Management Company LLC; United States; Remote; USD 28,000 - 48,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K plans

Stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Job summary

Centene Management Company LLC is hiring for a Prior Authorization Support role in the Little Rock, AR area. You will work with the utilization management team to ensure timely and accurate processing of authorization requests within contractual timelines, and gather documentation for services related to member eligibility.

The position requires 2–4 years of related experience and a high school diploma or GED, with eligibility to work in the U.S. and a flexible approach to scheduling.

Qualifications

• Requires knowledge of prior authorization review process.
• Ability to research insurance coverage and benefits.
• Strong medical terminology knowledge.
• Excellent data entry and documentation skills.
• Ability to communicate with clinical reviewers and providers.

Responsibilities

• Track and maintain authorization requests per guidelines.
• Verify member insurance coverage and eligibility.
• Enter data into the utilization management system.
• Provide guidance on authorization requirements for referrals.
• Support clinical reviewers with necessary medical information.
• Maintain relationships with providers to address referrals timely.

Skills

Prior authorization

Utilization management

Insurance verification

Documentation

Medical terminology

Data entry

Education

High School diploma or GED

Job description

Centene Management Company LLC is hiring for a Prior Authorization Support role in the Little Rock, AR area. You will work with the utilization management team to ensure timely and accurate processing of authorization requests within contractual timelines, and gather documentation for services related to member eligibility.

The position requires 2–4 years of related experience and a high school diploma or GED, with eligibility to work in the U.S. and a flexible approach to scheduling.