Authorization Specialist II

Centene Corporation

. Act as a resource and support the prior authorization request process .

Posted 10/12/2026full-timeRemote • Missouri • United StatesJunior💰 $18 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing prior authorization requests and ensuring compliance with healthcare policies and procedures. Proficient in verifying insurance coverage and maintaining accurate documentation for healthcare services.

Highest-signal resume keywords

Prior Authorization ManagementMedical Terminology KnowledgeUtilization Management SupportData Entry and DocumentationInsurance Coverage Verification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior Authorization ProcessUtilization Management SystemData EntryMedical DocumentationHealthcare Eligibility Verification

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Healthcare AuthorizationInsurance PoliciesContractual TimelinesClinical ReviewMember Services

About the role

Key responsibilities & impact

Act as a resource and support the prior authorization request process
Ensure authorization requests are addressed properly within contractual timelines
Support the utilization management team in documenting authorization requests
Obtain accurate and timely documentation for services related to members’ healthcare eligibility and access
Maintain ongoing tracking and appropriate documentation on authorizations and referrals
Research and document medical information such as history, diagnosis, and prognosis for clinical review
Verify member insurance coverage and service/benefit eligibility using system tools
Align authorizations with guidelines to ensure timely payment adjudication
Perform data entry to maintain and update authorization requests in the utilization management system
Process authorization requests according to the insurance prior authorization list
Route requests to the appropriate clinical reviewer
Remain current on healthcare authorization processes, policies, and procedures
Perform other duties as assigned

Requirements

What you’ll need

Qualified candidates must be located in the state of Missouri
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
High School diploma or GED required
1–2 years of related experience required
Knowledge of medical terminology and insurance preferred
Must comply with all policies and standards

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
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