"Alerted.org

You could be the one who changes everything for our 28 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.

This is an on-site position. Candidate must live in New York City, NY.

**Position Purpose:** Assist in activities related to the running of an office or program.

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

+ Research claims inquiry specific to the department and responsibility.

+ Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services.

+ Screen members by priority for case management (CM) assessment.

+ Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.

+ Answer calls on switchboard to make proper connections to requested personnel; greet and assist walk-in customers.

+ Produces and mails routine CM letters and program educational material.

+ Data enter assessments and authorizations into the system.

**Education/Experience:** High school diploma or equivalent. 1 - 2 years of related experience. Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer. Experience using Excel at an intermediate level is preferred. Effective written and verbal communication skills for email correspondence and member interactions are preferred.

Pay Range: $15.58 - $26.73 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act