Authorization Specialist II at BC Forward in Temple Terrace, Florida

Job Description:

Authorization Specialist II



BCForward is looking for Authorization Specialist- Tampa, FL 33618




Job Title: Authorization Specialist




Location: Tampa, FL 33618




Duration: 6 Months




Job Type: Contract to Hire




Pay Rate: $25/hr on W2




Shift : Monday - Friday 9:00 AM - 6:00 PM




**Job Title: Prior Authorization Specialist**


**Position Purpose:**
The Prior Authorization Specialist serves as a key resource in supporting the prior authorization request process, ensuring all requests are managed and addressed within the contractual timelines. This role assists the utilization management team by documenting authorization requests, obtaining accurate and timely documentation related to members' healthcare eligibility and access, and facilitating smooth operations within the authorization process.







**Education/Experience:**

- High School diploma or GED required.
- 1 - 2 years of related experience preferred.
- Knowledge of medical terminology and insurance processes is advantageous.



**Key Responsibilities:**

- **Authorization Support:** Aid the utilization management team by maintaining ongoing tracking and appropriate documentation of authorizations and referrals, adhering to policies and guidelines.
- **Information Research:** Assist in the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis. Prepare referrals for clinical review to determine authorization.
- **Insurance Verification:** Verify member insurance coverage and service/benefit eligibility using system tools. Ensure that authorizations align with guidelines for timely adjudication and payment.
- **Data Entry:** Perform data entry tasks to maintain and update authorization requests in the utilization management system.
- **Request Processing:** Process authorization requests for services in accordance with the insurance prior authorization list, and route them to the appropriate clinical reviewer.
- **Policy Compliance:** Stay informed about healthcare authorization processes, policies, and procedures to ensure compliance and effective operation.
- **Additional Duties:** Perform other duties as assigned to support the overall efficiency and effectiveness of the team.



**Skills and Competencies:**

- Strong attention to detail and organizational skills.
- Ability to handle multiple tasks and prioritize effectively.
- Excellent communication skills, both verbal and written.
- Proficient in using computer systems and data entry.
- Familiarity with healthcare authorization processes and insurance guidelines is beneficial.

**Compliance:**

- Adhere to all relevant policies, standards, and regulations.



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 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 228990 when responding to this ad.


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Job Snapshot




Employee Type

Contractor



Location

Temple Terrace, FL (Onsite)



Job Type

Health Care



Experience

Not Specified



Date Posted

09/10/2024