Position Title: Authorization Specialist I (Remote) Locations: Remote - California Anticipated Start Date: 11/18Expected Duration: 3 months Job Type: Contract with extension and possible Temp to Perm. Pay Rate: $17.00/hr on W2Shift: 8-5 Monday-Friday PST-No flexibility in schedule!!!Need: Min 1 year of Medical Terminology experience and must be able to type 50+ WPM due to high volume of work . Must take a Typing test and should achieve desired min 50WPM .
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.
Walk me through the day to day responsibilities of this the role and a description of the project :
• Receive faxes, triage them, and send out to the appropriate teams within Superior HealthPlan
• Supporting intake department to streamline the intake process
• Candidate needs to be comfortable typing fast and inputting data through the day
• Enters pertinent claims information from source documents
• Corrects entries where indicated.
• Maintains appropriate records, files, documentation, etc.
• Processing for teams including Concurrent Review, Behavioral Health, and Medicare, etc. - department is open 7 days/week because of this level of exposure to the business.
• 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
• Receive faxes, triage them, then verify/enter the data present on the forms
Describe the performance expectations/metrics for this individual and their team:
• Team will process anywhere from 3,500 to 4,000 faxes per day - need to get the faxes out to other teams within 1-2 hours of receiving, depending on the form
• 10,000 keystrokes an hour - 50 to 60 WPM, very fast-paced team
Tell me about what their first day looks like:
• Training is currently 4 days remote, then remote until further notice.
o Day 1: Meet with Jerald on Teams chat, will be set up to work remotely.
o Days 2 to 4: Begin training, day 4 will be a 'day in the life' to get better acquainted with team's processes.
Required Skills/Experience:
10,000 Keystrokes alphanumeric per hour needed %3D 50 WPM. Typing test or score need to be on top of the resume.
Ability to be punctual and reliable on the job
Preferred Skills/ Experience:
3 months to 1 year of data processing or clerical experience preferred, but not required
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.
Keywords:
[Change records, Change Controller, Planned Events and Approvals, Inspection readiness]
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 230608 when responding to this ad.
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