About the Role
Centene is dedicated to transforming the health of communities, impacting the lives of 28 million members. As a diversified, national organization, we offer competitive benefits and a fresh perspective on workplace flexibility.
Important Notice: This role requires U.S. work authorization without the need for future employment-based visa sponsorship. Sponsorship is not available for this position.
- Work Schedule: Remote, available anywhere in the United States. Monday - Friday, 12:00 p.m. - 9:00 p.m. EST.
Position Purpose
The Insurance Verification Specialist is responsible for obtaining and verifying complete insurance information, managing the prior authorization process, coordinating copay assistance, and handling coordination of benefits.
Key Responsibilities
- Obtain and verify insurance eligibility for services, documenting all information in the system.
- Perform prior authorizations as required by payors, collaborating with physician offices and insurance companies to gather necessary documentation.
- Collect required clinical information, such as lab values and diagnosis codes.
- Determine patient financial responsibilities based on insurance details.
- Configure coordination of benefits information for every referral.
- Ensure assignment of benefits are obtained and on file for Medicare claims.
- Bill insurance companies for provided therapies.
- Document all pertinent communications with patients, physicians, and insurance companies related to collections.
- Identify and coordinate patient reimbursement resources, including copay cards, third-party assistance programs, and manufacturer assistance programs.
- Handle inbound calls from patients, physician offices, and insurance companies.
- Resolve claim rejections related to eligibility, coverage, and other issues.
- Perform other duties as assigned.
- Comply with all company policies and standards.
Qualifications
- High school diploma required.
- Minimum of 1 year of experience in medical billing or insurance verification.
- A Bachelor's degree in a related field may substitute for the experience requirement.
- Experience with payors and prior authorization is preferred.
Compensation
- Pay Range: $15.87 - $27.25 per hour
Benefits
Centene offers a comprehensive benefits package, including:
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible work arrangements (remote, hybrid, field, or office)
Note: Actual pay will be determined by factors such as skills, experience, education, and other job-related factors permitted by law. Total compensation may include additional incentives. Benefits are subject to program eligibility.
Equal Opportunity Employer
Centene is an equal opportunity employer committed to diversity and inclusion. 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 any 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.