Referral Specialist II at Centene

Job Details

Location: Woodland Hills, Los Angeles, Los Angeles County, California, 91364, USA Posted: Dec 27, 2019

Job Description

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.

About Centene

Centene is a multi-line health care enterprise offering Medicaid managed care and specialty services.

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