Prior Authorization Clinician

BCforward is currently seeking a highly motivated Prior Authorization Clinician for an opportunity in Austin, TX.

Position Title: Prior Authorization Clinician

Location: Austin, TX

Anticipated Start Date: April 07th, 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: 9+ months (with possibility of extension)

Job Type: Contract, 40 HRS WEEKLY, Onsite

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.).

• Insurance Claims
• Comprehensive Care Program Experience highly preferred: Private Duty nursing. Home Health experience. Comprehensive Care Program Experience.
• The Licensed Vocational Nurse or Registered Nurse conducts pre-service, concurrent/ retrospective reviews.
• They will collaborate with healthcare providers to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
• They will ensure medically appropriate, high-quality, cost-effective care through assessing the medical necessity of outpatient services, out of network services, and appropriateness of treatment setting within the scope of professional limitations by utilizing the applicable rules of the Texas Administrative Code (TAC).

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.

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 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.

Interested candidates please send resume in Word format Please reference job code 235186 when responding to this ad.