← all jobs

Authorization Specialist I

Work from home Full-time role Hiring

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. 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.

  • 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 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

More open positions

Prior Authorizations Representative | Full Time, Days US - Remote (Any location)

Work from home Full-time role

Prior Authorization Specialist, Full Time

Work from home Full-time role

Prior Authorization Support Representative

Work from home Full-time role

Health Coach; Remote; Remote

Work from home Full-time role

Health Coach - Value Based Care (Must Reside in Florida)

Work from home Full-time role

Remote Occupational Therapy in OR

Work from home Full-time role

Experienced Data Entry Specialist – Remote Amazon Data Entry No Experience – Part-time Opportunity at careerzynith

Work from home Full-time role

Sales Agent for Moving and Cleaning Company

Work from home Full-time role

Remote Technical Support & Customer Service Representative – Home‑Based Tech Troubleshooting & Client Experience Specialist for careerzynith

Work from home Full-time role

Business Manager, Export Markets

Work from home Full-time role

Senior Account Executive

Work from home Full-time role

Remote Part-Time Data Entry Specialist – Flexible Hours with careerzynith

Work from home Full-time role

Finops Analyst - Temporary [Remote]

Work from home Full-time role

Remote Medical Transcriptionist Jobs | Work From Home | Full-Time

Work from home Full-time role

AI Adoption and IT Alignment Lead

Work from home Full-time role

Collections Clerk

Work from home Full-time role

Sr. Technical Program Manager, Professional Services - Public Sector

Work from home Full-time role

Counsel - Dallas, TX (Remote)

Work from home Full-time role

Motion Graphics Designer [Remote]

Work from home Full-time role

Program Manager, Emergency Preparedness

Work from home Full-time role

Business Analytics Advisor, Payment Integrity – Risk & Affordability (Remote)

Work from home Full-time role