Authorization Specialist Ii

hace 2 meses


La Florida, Chile BCforward A tiempo completo

Authorization Specialist II

**BC Forward is looking for **Authorization Specialist II (Remote)**

**Position Title: Authorization Specialist II (Remote)**
**Location : REMOTE - FL (EST/CST)**
**Anticipated Start Date: 10/23**
**Expected Duration: 6 months**
**Job Type: Contract with possible extension**
**Shift: (Tuesday through Saturday (hours would be between 7 am and 7 pm - 8-hour shifts), (overtime available on a weekly basis)**
**Pay rate: $19.00/hr on W2**
**Need: Min 1-2 years of experience with Medical Terminnology and Data Entry (Min 60WPM). Must go through a Data Entry Assesment and must secure TYPING SPEED - 60WPM**
***

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

Working within multiple systems (FaxCom, TruCare, Microsoft Platforms, etc.) to review authorization requests from providers.
If the request does not have enough detail, a fax must be sent back to the provider to gather additional details.
May be requested to complete stretch assignments or jump into assist in other areas based on work volumes.
Open to change and being able to work through changes in business.

Describe the performance expectations/metrics for this individual and their team:
30 - 35 authorization request(s) REQUIRED per day

Required Skills/Experience:
Requires 1 - 2 years of related experience.
Detail oriented
Accountability
Must be able to work with multiple systems at a time
Strong understanding of computers / technology

Education/Experience:
Requires a High School diploma or GED
Requires 1 - 2 years of related experience.

Knowledge of medical terminology and insurance preferred.Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines

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

Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment

Performs data entry to maintain and update various authorization requests into utilization management system

Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer

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.

**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.

**Employee Type**: Contractor

**Location**: Florida, FL (Onsite)

**Job T



  • La Florida, Chile BCforward A tiempo completo

    Authorization Specialist II **BC Forward is looking for **Authorization Specialist II (Remote)** **Position Title: Authorization Specialist II (Remote)** **Location : REMOTE - FL (EST/CST)** **Anticipated Start Date: 10/23** **Expected Duration: 6 months** **Job Type: Contract with possible extension** **Shift: (Tuesday through Saturday (hours would be...


  • La Florida, Chile BCforward A tiempo completo

    Authorization Specialist **BCforward is currently seeking a highly motivated Authorization Specialist for an opportunity in Remote - FL!** **Position Title**:Authorization Specialist** **Location**: Remote - FL** **Anticipated Start Date**: 9/9/2024** **Expected Duration**:6+ Months of contract with possible extension** **Job Type**: [FULL TIME (>%3D30...

  • Appeals Specialist Ii

    hace 4 meses


    La Florida, Chile BCforward A tiempo completo

    Appeals Specialist II **BC Forward is looking for **Appeals Specialist II (Remote)** **Position: Appeals Specialist II (Remote)** **Location: REMOTE EST** **Anticipated Start : ASAP** **Duration: 6 months** **Job Type: Contract with possible extension** **Shift: 8am-5pm EST** **Pay-Rate: $24/Hr. on W2** Supports the documentation and processing of...

  • Appeals Specialist

    hace 4 meses


    La Florida, Chile BCforward A tiempo completo

    Appeals Specialist **BCforward is currently seeking a highly motivated Appeals Specialist for an opportunity in Remote!** **Position Title**:Appeals Specialist** **Location**: Remote** **Anticipated Start Date**: 9/23/2024** **Expected Duration**:3+ Months of contract with possible extension** **Job Type**: [FULL TIME (>%3D30 HRS WEEKLY)], [CONTRACT],...


  • La Florida, Chile Alcon A tiempo completo

    At Alcon, we are driven by the meaningful work we do to help people see brilliantly. We innovate boldly, champion progress, and act with speed as the global leader in eye care. Here, you’ll be recognized for your commitment and contributions and see your career like never before. Together, we go above and beyond to make an impact in the lives of our...

  • Nurse Oncology Specialist

    hace 4 semanas


    La Florida, Chile Vitalassoc A tiempo completo

    Job SummaryVitalassoc is seeking a highly skilled Nurse Oncology Specialist to join our team. In this role, you will provide direct patient care in support of ADLs, educational, spiritual and psychological support, and pain management & medication administration.About the RoleProvide chemotherapy medications as prescribed within facility policy and...


  • La Florida, Chile Cencora A tiempo completo

    - What you will be doing Play a vital role in helping patients gain access to life changing therapies! From oral medications to biosimilars to critical cancer treatments to infusions, our associates, with their passion for patients, represent these therapies providing education, coverage, and access solutions to healthcare personnel.Field Reimbursement...


  • La Florida, Chile Vitalassoc A tiempo completo

    Job SummaryVitalassoc seeks a skilled Registered Nurse Telemetry to join our team. As an Intensive Care Nurse Specialist, you will provide direct hands-on care for patients admitted to the inpatient units throughout BPVAHCS.About the RoleThe ideal candidate will possess superior critical thinking skills to prevent or respond to emergency situations and have...


  • La Florida, Chile Vitalassoc A tiempo completo

    Job Summary:The Emergency Department Nurse Specialist at Vitalassoc plays a critical role in delivering high-quality patient care in a fast-paced environment. As a skilled nurse, you will be responsible for assessing patients' conditions, developing and implementing effective treatment plans, and collaborating with the healthcare team to ensure seamless care...


  • La Florida, Chile Alcon A tiempo completo

    At Alcon, we are driven by the meaningful work we do to help people see brilliantly. We innovate boldly, champion progress, and act with speed as the global leader in eye care. Here, you’ll be recognized for your commitment and contributions and see your career like never before. Together, we go above and beyond to make an impact in the lives of our...


  • La Florida, Chile Alcon A tiempo completo

    At Alcon, we are driven by the meaningful work we do to help people see brilliantly. We innovate boldly, champion progress, and act with speed as the global leader in eye care. Here, you’ll be recognized for your commitment and contributions and see your career like never before. Together, we go above and beyond to make an impact in the lives of our...


  • La Florida, Chile Alcon A tiempo completo

    At Alcon, we are driven by the meaningful work we do to help people see brilliantly. We innovate boldly, champion progress, and act with speed as the global leader in eye care. Here, you’ll be recognized for your commitment and contributions and see your career like never before. Together, we go above and beyond to make an impact in the lives of our...


  • La Florida, Chile Alcon A tiempo completo

    At Alcon, we are driven by the meaningful work we do to help people see brilliantly. We innovate boldly, champion progress, and act with speed as the global leader in eye care. Here, you’ll be recognized for your commitment and contributions and see your career like never before. Together, we go above and beyond to make an impact in the lives of our...


  • La Serena, Coquimbo, Chile NOIRLab A tiempo completo

    About the RoleWe are seeking a highly skilled High-Tech Mechanical Specialist to join our team at NOIRLab, a premier US national center for ground-based, nighttime optical and infrared astronomy.Job SummaryThis is an exciting opportunity to work on complex mechanical, opto-mechanical or electro-mechanical systems, designing and implementing solutions that...


  • La Florida, Chile AAA The Auto Club Group A tiempo completo

    It’s a great time to join AAA The Auto Club Group! JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD **Job Type**: Full time Exempt/Non Exempt: Salary **Job Description**: Reports to (job title): Life Sales Manager I. Position Description Primary Duties and Responsibilities (details of the basic job functions): The Life and Annuity Agent will...