Authorization Specialist II

Centene Corporation

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

Posted 10/12/2026full-timeRemote • Florida • 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 utilization management.

Highest-signal resume keywords

Prior Authorization ProcessMedical Terminology KnowledgeUtilization Management SupportData Entry SkillsInsurance Coverage Verification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Authorization Request ManagementDocumentation TrackingClinical Information ResearchBenefit Eligibility VerificationData Maintenance

Tools & Technologies

Utilization Management System

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Healthcare ComplianceAuthorization GuidelinesInsurance PoliciesClinical Reviewer Support

About the role

Key responsibilities & impact

Act as a resource and support the prior authorization request process
Ensure authorization requests are addressed properly within the contractual timeline
Support the utilization management team with documentation and tracking of authorization requests and referrals
Research and document medical information such as history, diagnosis, and prognosis for clinical reviewer determination
Verify member insurance coverage and service/benefit eligibility using system tools
Align authorizations with guidelines to ensure timely adjudication for payment
Perform data entry to maintain and update authorization requests in the utilization management system
Process authorization requests according to the insurance prior authorization list and route them to the appropriate clinical reviewer
Stay current 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
Must live in the state of Florida
High School diploma or GED
1–2 years of related experience
Knowledge of medical terminology and insurance preferred
Compliance with all policies and standards

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plan
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
Equal opportunity employer committed to diversity