Prior Authorization System Coordinator
Company: Centene Corporation
Location: Lincoln
Posted on: January 25, 2023
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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
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