Authorization Specialist II

Authorization Specialist II

BCForward is looking for Authorization Specialist II- Remote

Position: Authorization Specialist II
Duration: 6+ Months
Work Location: Remote (NC EST)
Possibility to Extend or Convert: Yes

Pay Rate: $19.50/hr on W2

Schedule: 8 AM to 5 PM, including weekends.

Main Purpose:

• The main purpose of the Authorization Specialist II role is to verify insurance coverage and eligibility for medical services, ensuring timely payment adjudication. This position supports the authorization review process by documenting necessary medical information and maintaining accurate authorization records. Ultimately, it facilitates efficient patient care and compliance with healthcare policies.

Key Responsibilities:

• Support the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis for clinical review.
• Verify member insurance coverage and service/benefit eligibility using system tools to ensure timely payment adjudication.
• Perform data entry to maintain and update various authorization requests in the utilization management system.
• Process authorization requests for services according to the insurance prior authorization list and route to the appropriate clinical reviewer.
• Stay updated on healthcare authorization processes, policies, and procedures.
• Perform other duties as assigned while complying with all policies and standards.
• Team Interaction: Participate in Group Teams chat, follow-up emails for record-keeping, weekly team huddles (Tuesdays), and monthly 1:1 meetings to meet goals.

Education/Certification:

• High School diploma or GED required.
• 1-2 years of related experience required.

Qualifications:

• Must-Haves:
• 1-2 years of related experience, particularly in customer service with internal/external members.
• Strong technical skills to navigate systems effectively.
• Reliable internet service and commitment to the schedule.

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.

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• 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 for 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 236206 when responding to this ad.

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