Job Description
Job Description
BCforward is currently seeking a highly motivated Authorization Specialist II for an opportunity in Remote, FL
Position Title: Authorization Specialist II
Location: Remote, FL
Duration: 3 months of contract with possible extension (Contract to Hire)
Shift: 8-5 Monday – Friday
Pay Rate: $19.00/hr. on W2
Job Description:
Acts as a resource and supports the prior authorization request process to ensure all requests are addressed within contractual timelines. Assists the utilization management team in documenting authorization requests and obtaining accurate, timely documentation for services related to members’ healthcare eligibility and access.
Education/Experience:
- High School diploma or GED required
- 1–2 years of related experience required
- Knowledge of medical terminology and insurance preferred
Responsibilities:
- Assist the utilization management team by maintaining ongoing tracking and proper documentation of authorizations and referrals in accordance with policies and guidelines.
- Support the authorization review process by researching and documenting necessary medical information (history, diagnosis, prognosis) for referral to the clinical reviewer.
- Verify member insurance coverage and service/benefit eligibility using system tools, ensuring authorizations align with guidelines for timely adjudication and payment.
- Perform data entry to maintain and update authorization requests in the utilization management system.
- Support and process authorization requests for services according to the prior authorization list, routing to the appropriate clinical reviewer.
- Stay up to date on healthcare authorization processes, policies, and procedures.
- Perform other duties as assigned.
- Comply with all policies and standards.
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.