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Referral Specialist II

Company: Centene
Location: Des Moines
Posted on: March 17, 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. Job Requirements Education/Experience: High school Diploma or equivalent. Bilingual in Spanish preferred. 3+ years of customer service experience. Knowledge of medical terminology preferred. 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. Apply on Company Website Job ID: ******* For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more. Centene Iowa Total Care is committed to providing solutions for Medicaid members throughout Iowa. Iowa Total Care, a wholly-owned subsidiary of Centene, provides coordinated healthcare, pharmacy, vision and transportation services to members of the health plan. Iowa Total Care works closely with Primary Care Providers (PCPs) and our enrolled members in providing comprehensive care coordination ensuring their medical needs are met. We partner with physicians, specialists, hospitals, and other providers, such as pharmacy and vision, to ensure that each member receives quality healthcare. Contact Info - Des Moines, IA Don't miss out on new jobs like this Get the latest jobs delivered to your inbox. Unsubscribe at any time. Create Job Alert Saving Your Job Alert Job Alert Created Well, this is embarrassing. We are having trouble saving your search. You can try again or come back at a later time. Maximum Email Alerts This email address has reached the maximum of 5 email alerts. To create a new alert, you will need to log into your email and unsubscribe from at least one.

Keywords: Centene, Des Moines , Referral Specialist II, Other , Des Moines, Iowa

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