Authorization Specialist I – Medicare

Centene Corporation

. Support prior authorization requests to ensure they are addressed properly and within contractual timelines .

Posted 10/5/2026full-timeRemote • New York • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates proficiency in managing prior authorization requests and documentation within healthcare settings, ensuring compliance with policies and guidelines. Possesses a solid understanding of medical terminology and insurance processes to support effective utilization management.

Highest-signal resume keywords

Prior Authorization ManagementMedical Terminology UnderstandingUtilization Management SupportData Entry SkillsHealthcare Policy Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data EntryDocumentationAuthorization Request ProcessingHealthcare Eligibility VerificationUtilization Management System Proficiency

Soft Skills

Attention to DetailOrganizational SkillsCommunication Skills

Tools & Technologies

Utilization Management System

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Medicare ExperienceHealthcare PoliciesAuthorization ProcessesInsurance Compliance

About the role

Key responsibilities & impact

Support prior authorization requests to ensure they are addressed properly and within contractual timelines
Aid the utilization management team in documenting authorization requests
Obtain accurate and timely documentation for services related to members' healthcare eligibility and access
Support authorization requests in accordance with the insurance prior authorization list
Perform data entry to maintain and update authorization requests in the utilization management system
Assist with tracking and documentation of authorizations and referrals according to policies and guidelines
Document medical information such as history, diagnosis, and prognosis for clinical reviewer determination
Stay up-to-date on healthcare, authorization processes, policies, and procedures
Perform other duties as assigned

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Medicare experience preferred
High School diploma or GED required
Understanding of medical terminology and insurance preferred
Entry-level position typically requiring little or no previous experience
Ability to comply with all policies and standards

Benefits

Comp & perks

competitive pay
health insurance
401K
stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules
additional forms of incentives may be included in total compensation