Authorization Specialist I

BCforward is currently seeking a highly motivated Authorization Specialist I for an opportunity in Remote !

Position Title: Authorization Specialist I

Location: Remote (CST or EST preferred)

Anticipated Start Date: April 28, 2025

Please note this is the target date and it is subject to change. BCforward will send official notice ahead of a confirmed start date.

Expected Duration: 12+ Months of contract with possible extension

Job Type: [FULL TIME (>%3D30 HRS WEEKLY], [CONTRACT], [Remote]

Pay Range: $24

Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).

Daily Schedule:

• First Day: 8:00 AM - 4:30 PM CT
• Training Schedule: 10:00 AM - 6:30 PM CT
• Working Schedule: Monday - Friday, 1:30 PM - 10:00 PM CT

Position Purpose:

The Authorization Specialist I plays a crucial role in supporting the prior authorization request process, ensuring that all requests are properly addressed within contractual timelines. This position aids the utilization management team in documenting and obtaining accurate and timely information regarding services related to the member's healthcare eligibility and access.

Education/Experience:

• Required: High School diploma or GED
• Preferred: Basic understanding of medical terminology and insurance
• Entry-level position requiring minimal to no previous experience

Responsibilities:

• Support and perform data entry to maintain and update authorization requests within the utilization management system
• Assist the utilization management team by tracking and ensuring proper documentation of authorizations and referrals, adhering to company policies and guidelines
• Contribute to the authorization review process by gathering necessary medical information (e.g., history, diagnosis, prognosis) for clinical review and determination
• Stay updated on healthcare-related policies, authorization processes, and procedures
• Perform other duties as assigned by the supervisor
• Ensure compliance with all relevant policies and standards

Candidate Value Proposition:

• Opportunity to work in a dynamic, collaborative environment across multiple health plans.
• Gain valuable experience in authorization processes and utilization management.
• Enjoy a balance of support and autonomy in completing tasks without micromanagement.

Candidate Requirements:

Required:

• High School diploma or GED

Preferred:

• 1 year of experience in data entry
• Familiarity with medical terminology and insurance

Must-Haves:

Disqualifiers:

• Previous negative reviews from Centene

Performance Indicators:

• Must be able to engage with the application for a minimum of 6.5 hours during an 8-hour workday.
• Expected average productivity is 126 faxes sorted per hour, or 62 faxes keyed per hour.

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 236976 when responding to this ad.