Authorization Specialist II Job at Centene Corporation, Sacramento, CA

SktOOU1JV1hWUjgxUm8rcVZMT0pBaVJtTWc9PQ==
  • Centene Corporation
  • Sacramento, CA

Job Description

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. **Candidates must be available to work on Saturdays. Hours are 10am to 8pm PST.** **Position Purpose:** Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access. + Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines + Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination + Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment + Performs data entry to maintain and update various authorization requests into utilization management system + Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer + 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. Requires 1 - 2 years of related experience. Knowledge of medical terminology and insurance preferred. Pay Range: $17.50 - $27.50 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. Total compensation may also include additional forms of incentives. 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

Job Tags

Hourly pay, Holiday work, Remote job, Flexible hours, Saturday,

Similar Jobs

Inframark, LLC

Facility Maintenance - HVAC and Plumbing Job at Inframark, LLC

 ...function of the position within the organization is to perform skilled work in the maintenance of facilities. The position is responsible for performing carpentry, electrical, HVAC and plumbing tasks in the maintenance, repair and construction of assigned facilities. The... 

CommonSpirit Health

Real Estate Lease Analyst Job at CommonSpirit Health

**Responsibilities**The Real Estate Lease Analyst is responsible for independently managing the integrity of real estate portfolio data for a complex portfolio and providing related direct support to the Corporate Real Estate team. This includes all the responsibilities... 

Hold Brothers

Proprietary US Equities Trader/Active Job at Hold Brothers

 ...About the Job: Hold Brothers Capital, LLC, is a FINRA Registered, SEC, Self-Clearing Broker Dealer. We strive to be a complete destination for traders looking to maximize their performance in todays financial markets. We trade the US Equity Markets only. Our proprietary... 

iSoftTek Solutions Inc

Electrical Engineer / Designer Job at iSoftTek Solutions Inc

 ...Job Description: Responsibilities: Perform full design of lighting, power, and fire alarm systems, including full equipment...  ...Requirements Requirements: Bachelor's degree in Electrical Engineering or Architectural Engineering with an electrical focus... 

Leap Brands

Chief Marketing Officer - Home Services Job at Leap Brands

 ...Position Summary: We are seeking a dynamic and results-oriented Chief Marketing Officer (CMO) to lead and scale our marketing strategy across digital and traditional channels. As the company experiences rapid growth and expansion, the CMO will play a pivotal role in...