Authorization Specialist III

Centene Corporation

. Work with the utilization management team to support the prior authorization request process .

Posted 10/6/2026full-timeRemote • United StatesJuniorMid-Level💰 $20 - $35 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in prior authorization processes and medical terminology, ensuring accurate documentation and compliance with healthcare policies. Proficient in utilizing management systems for tracking and managing authorization requests effectively.

Highest-signal resume keywords

Prior Authorization ProcessesMedical TerminologyUtilization Management SystemsInsurance Coverage KnowledgeDocumentation and Tracking

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Authorization Request ManagementHealthcare Eligibility VerificationData EntryResearch SkillsPolicy Compliance

Soft Skills

Relationship ManagementCommunication Skills

Tools & Technologies

Utilization Management System

Industry Keywords

Healthcare AuthorizationInsurance PoliciesReferral Authorization RequirementsService AccessClinical Review

About the role

Key responsibilities & impact

Work with the utilization management team to support the prior authorization request process
Ensure authorization requests are addressed properly within contractual timelines
Document complex authorization requests and obtain accurate, timely documentation for member healthcare eligibility and service access
Track and maintain authorization requests according to the insurance prior authorization list
Route requests to appropriate clinical reviewers
Verify member insurance coverage and service or benefit eligibility
Enter and update complex authorization requests in the utilization management system
Maintain tracking and documentation for authorizations and referrals
Research providers, policies, preferred in-network providers and referral authorization requirements
Provide supporting documentation to health plans
Research and document medical information for clinical reviewer determinations
Maintain relationships with service providers and clinical reviewers
Act as a subject matter expert for team members across authorization processes and service types
Remain current on healthcare authorization processes, policies and procedures
Perform other duties as assigned

Requirements

What you’ll need

Must be located in the greater Little Rock, AR area
Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future
High School diploma or GED
Requires 2–4 years of related experience
Strong knowledge of medical terminology and insurance
Knowledge of prior authorization processes, insurance coverage, policies and procedures
Ability to research health plan providers, policies, referral authorization requirements, medical history, diagnosis and prognosis
Ability to use system tools and utilization management systems for data entry and authorization tracking
Must comply with all policies and standards

Benefits

Comp & perks

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