Authorization Specialist II

Centene Corporation

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

Posted 9/15/2026full-timeRemote • New York • United StatesJunior💰 $18 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in managing prior authorization requests, ensuring compliance with insurance policies and guidelines, and maintaining accurate documentation within a utilization management system. Proficient in verifying insurance coverage and eligibility while staying updated on healthcare processes and standards.

Highest-signal resume keywords

Prior Authorization ManagementMedical Terminology KnowledgeData Entry in Utilization Management SystemInsurance Coverage VerificationDocumentation of Medical Information

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Prior Authorization Request ProcessingMedical Information ResearchData EntryUtilization ManagementInsurance Policy Compliance

Soft Skills

Attention to DetailOrganizational SkillsCommunication Skills

Tools & Technologies

Utilization Management System

Industry Keywords

HealthcareAuthorization ProcessesInsurance GuidelinesBenefit EligibilityContractual Timelines

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 with documentation and tracking of authorization requests and referrals
Research and document medical information for referral to clinical reviewers
Verify member insurance coverage and service/benefit eligibility
Align authorizations with guidelines to support timely payment adjudication
Enter 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 up-to-date on healthcare, authorization processes, policies, and procedures
Comply with all policies and standards
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
High School diploma or GED
Requires 1–2 years of related experience
Knowledge of medical terminology and insurance preferred
Ability to research and document medical information such as history, diagnosis, and prognosis
Ability to verify member insurance coverage and service/benefit eligibility using system tools
Ability to perform data entry and maintain authorization requests in a utilization management system
Ability to follow insurance prior authorization lists, policies, guidelines, and procedures

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
Equal opportunity employer committed to diversity