Job Description
Job Description
BC Forward is looking for Authorization Specialist II (Remote OH) in Ohio
Position: Authorization Specialist II (Remote OH)
Location: Remote OH
Anticipated Start date : 10/20
Duration: 6 months Contract with extension
Shift Schedule: 8am to 5pm
Pay Range: $23.00hr on W2
Need: 1–2 years of related administrative, healthcare, or insurance experience. Familiarity with health insurance and/or medical terminology
Interview Process: 1 - Video Screening, 2 - Virtual Interview.
Job Description:
Position Purpose
The Authorization Specialist supports the prior authorization process to ensure all requests are reviewed and completed within contractual timelines. This role works closely with the Utilization Management team to document authorization requests, verify eligibility, and obtain accurate and timely information needed for clinical review and member access to healthcare services.
Key Responsibilities
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Maintain accurate tracking and documentation of authorizations and referrals in alignment with policies and guidelines.
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Research and document necessary medical information (history, diagnosis, prognosis) to support clinical review determinations.
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Verify member insurance coverage, benefits, and service eligibility, ensuring alignment with guidelines for timely adjudication.
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Enter, update, and manage authorization requests within the utilization management system.
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Process requests according to the insurance prior authorization list, routing appropriately to clinical reviewers.
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Collaborate with the Authorization Specialist team and Concurrent Review Nurses to ensure smooth workflow.
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Stay current on healthcare policies, authorization processes, and procedures.
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Comply with company policies and standards, performing other related duties as assigned.
Education & Experience
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Required: High School diploma or GED
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Preferred: Knowledge of medical terminology and health insurance
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Experience: 1–2 years of related administrative, healthcare, or insurance experience
Candidate Profile
Must-Haves:
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Basic computer skills
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1–2 years of relevant work experience
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Strong sense of urgency and attention to detail
Nice-to-Haves:
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Familiarity with health insurance and/or medical terminology
Disqualifiers:
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Lack of minimum education or relevant experience
Role Value & Growth Opportunity
This position plays a critical role in supporting Utilization Management and the Concurrent Review team, directly impacting member access to care and operational efficiency. Joining Centene/Buckeye Health Plan offers exposure to healthcare operations within a nationally recognized organization, providing opportunities for career growth in clinical and administrative healthcare services.
Team & Work Environment
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Collaborative work with fellow Authorization Specialists and Concurrent Review Nurses.
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Structured daily tasks with opportunities for cross-team interaction.
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Supportive, team-oriented environment within the health plan business unit.
Company DescriptionAbout 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 places to work.
BCforward is an equal opportunity employer.
Company Description
About BCforward:\r\n\r\nFounded 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.\r\n\r\nBCforward 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 places to work.\r\n\r\nBCforward is an equal opportunity employer.