Authorization Specialist II

BCForward is looking for Authorization Specialist II- Remote- FL

Position Title: Authorization Specialist II

Location: Remote- FL

Anticipated Start Date: 03/24/2025

Expected Duration: 03+ Months of contract with possible extension

Job Type: [FULL TIME (>%3D40 HRS WEEKLY], [CONTRACT], [Remote]

Daily Schedule: Monday - Friday, 8 a.m. - 5 p.m.

Pay Range: $18.00/hr.

Position Purpose:

Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly within the contractual timeline. Supports the utilization management team in documenting authorization requests and obtaining accurate and timely documentation for services related to members' healthcare eligibility and access.

Responsibilities:

• Aid the utilization management team, maintaining ongoing tracking and documentation of authorizations and referrals in accordance with policies and guidelines.
• Support the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on referrals.
• Verify member insurance coverage and service/benefit eligibility via system tools and align authorization with guidelines for timely adjudication.
• Perform data entry to maintain and update authorization requests in the utilization management system.
• Process authorization requests for services in accordance with the insurance prior authorization list and route to the appropriate clinical reviewer.
• Remain up-to-date on healthcare, authorization processes, policies, and procedures.
• Perform other duties as assigned.

Education/Experience:

• Required: High School diploma or GED; 1-2 years of related experience.
• Preferred: Knowledge of medical terminology and insurance.

Skills and Qualifications:

• Familiarity with compliance and healthcare management systems.
• Experience with authorization, coding, and billing systems.
• Strong written, verbal, and interpersonal skills.
• Strong customer service skills.

Must-Have Skills:

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.

Keywords:

[Warehouse and Forklift.]

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 236364 when responding to this ad.