Referral Specialist Ii Jobs

You could be the one who changes everything for our 26 million members as a Customer Care professional at Centene. As a diversified, 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.
• Process referrals and refer, when appropriate to Case Managers.
• Initiate authorization requests for output or input services in keeping with the prior authorization list.
• Data enters authorizations into the system.
• Research claims inquiry specific to the department and the responsibility.
• Screen for eligibility and benefits. Answer phone queues and faxes within established standards.

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

Pay range: $19 - $37

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. The employee may be eligible for bonuses and other forms of compensation.

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.