Centene Corporation Hiring for Referral Specialist II – Remote Available in Illinois at Springfield, Illinois Full Time

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

Assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations and act as trainer and mentor to less experienced staff.

• Provide technical support to staff and provide ongoing training.

• Initiate authorization requests for output or input services in keeping with the prior authorization list.

• Research claims inquiry specific to the department and the responsibility.

• Process referrals and refer, when appropriate to Case Managers.

• Screen for eligibility and benefits. Answer phone queues and faxes within established standards.

• Data enters authorizations into the system.

Our Comprehensive Benefits Package:

• Flexible work solutions including remote options, hybrid work schedules and dress flexibility

• Competitive pay

• Paid Time Off including paid holidays

• Health insurance coverage for you and dependents

• 401(k) and stock purchase plans

• Tuition reimbursement and best-in-class training and development

Education/Experience : High school Diploma or equivalent. Bilingual in Spanish preferred. 3+ years of customer service experience. Knowledge of medical terminology preferred.

Once work from home orders have been lifted, position will be required to work in local Burr Ridge, IL office with the opportunity remote options and hybrid work schedules

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: Referral Specialist II – Remote Available in Illinois

LOCATION: Illinois, Illinois

REQNUMBER: 1265466