Referral Specialist

Centene Corporation (NYSE: CNC) is a leading managed care organization that provides Medicaid-related programs to organizations and individuals through government subsidized programs.  Superior HealthPlan of Texas, a subsidiary of Centene Corporation, is excited to offer the following position in the Austin area:

 

Referral Specialist

 

Position Purpose:

To assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations.

 

Knowledge/Experience:

High school degree or equivalent.At least 3 months experience in customer service, doctor?s office, utilization review, claims processing or provider relations. Experience in a managed care environment and knowledge of medical terminology preferred. 

 



Position Responsibilities:

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 cues and faxes within established standards.Data enters authorizations into the system.

 

Interested and qualified candidates should apply online at

www.centene.com