Authorization Specialist I

BC Forward is looking for

Authorization Specialist I (REMOTE WORK)

Position Title : Authorization Specialist I (REMOTE WORK)

Location : St. Louis, MO 63105 (Remote CST)

Anticipated Start Date : 5 / 27

Expected Duration : 6 months

Job Type : Contract with possible extension

Shift : Monday - Friday 8 : 00 a.m. - 5 : 00 p.m. Alternating Weekends, Saturday & Sunday (also 8 : 00 a.m. - 5 : 00 p.m.)

Pay Rate : $16.85 / hr on W2.

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.

Review faxes and process them into electronic medical record system.Accept phone calls from providers. (5 calls per day approximately)Complete 25-35 authorizations / phone calls a day

Required Skills / Experience : Customer serviceCustomer service

Preferred Skills / Experience : HCPS / CPT coding

Software Skills Required : Microsoft Office / Teams

Education / Experience : Requires a High School diploma or GEDEntry-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 proceduresPerforms 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.

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.

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 221962 when responding to this ad.

Last updated : 2024-05-08