Authorization Specialist II - Behavioral Health

Centene
New York
Workplace: RemoteFull timeUSD 17.84 - 28.02 hourlyFunction: Administration & Executive AssistanceExperience: 1-2 yearsEducation: high_schoolSkills: ["Accuracy","Documentation","Attention to detail","Time management","Communication"]

Support the prior authorization request process by assisting the utilization management team with documentation, tracking, and timely submission of authorization requests for behavioral health services. Verify member insurance coverage and eligibility, research and document medical information for clinical review, and maintain authorization/referral records in the utilization management system. Stay current on healthcare and authorization policies, procedures, and guidelines while completing data entry and routing requests appropriately.

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FursaFursa
Centene
Centene
2 days ago

Authorization Specialist II - Behavioral Health

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Source: Company careers pageValidated by: Fursa AI
Last checked: 19 hours agoStatus: Live

Job Summary

Support the prior authorization request process by assisting the utilization management team with documentation, tracking, and timely submission of authorization requests for behavioral health services. Verify member insurance coverage and eligibility, research and document medical information for clinical review, and maintain authorization/referral records in the utilization management system. Stay current on healthcare and authorization policies, procedures, and guidelines while completing data entry and routing requests appropriately.
Location: New York
Workplace: Remote
Employment Type: Full time
Job Function: Administration & Executive Assistance
Seniority: Entry level

Key Responsibilities

  • •Support the prior authorization request process within contractual timelines for behavioral health services.
  • •Aid utilization management with documentation, tracking, and maintenance of authorization requests and referrals.
  • •Research and document necessary medical information (history, diagnosis, prognosis) for clinical reviewer determination.
  • •Verify insurance coverage and service/benefit eligibility using system tools and align authorizations to guidelines for timely adjudication.
  • •Perform data entry to update authorization requests in the utilization management system and route requests to appropriate clinical reviewers.

Pay and Benefits

Salary: USD 17.84 - 28.02 hourly
Perks:Health Insurance401kEquityPaid LeavePaid HolidaysRemote Work

Key Requirements

  • •High school diploma or GED.
  • •1–2 years of related experience.
  • •Knowledge of medical terminology.
  • •Experience/knowledge in behavioral health is preferred.
  • •Ability to accurately document and maintain authorization and referral information in accordance with policies and guidelines.
Experience:1-2 years
Education:High School
Skills:AccuracyDocumentationAttention to detailTime managementCommunication

Eligibility

Visa:H-1BL-1O-1H-1B1F-1J-1OPTCPT
Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn