Prior Authorization System Coordinator

Company: Centene Corporation
Location: Lincoln
Posted on: January 25, 2023

Job Description:

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Perform duties to support the prior authorization team and ensure accurate claims payment and system configuration

--- Review authorization related check runs for claims and system configuration accuracy

--- Identify training opportunities for utilization management staff based on authorization review

--- Review and respond to non-clinical medical review authorization appeals, including sending copies of denial letters to the plans

--- Create and update medical review appeal and adjustment documentations

--- Maintain web based authorization pre-screen tools for members and providers

--- Compile authorization appeal reports for appeal tracking and trending

--- Maintain configuration grids for all health plans and post to internal site

Education/Experience: High school diploma or equivalent. 3+ years combined medical claims and managed care information systems experience.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

**TITLE:** Prior Authorization System Coordinator

**LOCATION:** Various, Nebraska

**REQNUMBER:** 1400231

Keywords: Centene Corporation, Lincoln , Prior Authorization System Coordinator, Other , Lincoln, Nebraska