Authorization Specialist I at BC Forward in Missouri City, Missouri

Job Description:

Authorization Specialist I



BC Forward is looking for Authorization Specialist I (Remote)


Position Title: Authorization Specialist I (Remote)


Location : REMOTE - CST


Anticipated Start Date: 10/14


Expected Duration: 12 months


Job Type: Contract to Hire


Shift: Monday - Friday, (2) days off candidate can choose to take (2) of the following three days off Tuesday, Wednesday, Thursday, - (Mondays & Fridays are NOT able to be taken off)


Hours for the weekend shift will be able to be selected either 7:30 am - 6:00 or 6:30 am -5:00 pm


During the week it would be 1:30 pm- 10:00 pm (training would still take place in the morning)


Pay Rate : $17.00/hr on W2


Note: Must take a Data Entry Test and Typing speed should be 60WPM .







Job Description:

Position Purpose:
Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.

• Data entry - the claim forms are submitted via fax, goes into system to become electronic. Pulling information off claim form and submitting position into database.
• Submitting member data into database.
• Team process 15,000 - 20,000 claims per day
• (1) claim to upload takes 30 - 60 seconds

• Monthly goal that will need to be met (Monthly goal 98%)
• All new hires are placed on a 90 day ramp up period where they are not required to meet this goal until they have established training and understanding of role.

• Quality standards 98%) - no ramp up on quality standard.
• Internal SLA - each claim form must be completed and uploaded within 2 hours of receipt.

Required Skills/Experience:
Data Entry - typing all day long (8 hours )
Medical background

Education/Experience:
Requires a High School diploma or GED
Entry-level position typically requiring little or no previous experience.

Understanding of medical terminology and insurance preferred.

Supports authorization requests for services in accordance with the insurance prior authorization list

Responsibilities: Supports and performs data entry to maintain and update authorization requests into utilization management system

Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines

Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination

Remains up-to-date on healthcare, authorization processes, policies and procedures
Performs other duties as assigned

Complies with all policies and standards


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.

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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 229930 when responding to this ad.


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Job Snapshot




Employee Type

Contractor



Location

Missouri City, MO (Onsite)



Job Type

Health Care



Experience

Not Specified



Date Posted

10/03/2024