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Denial Specialist II

4 months ago

Tulsa, United States BCforward Full time
Denial Specialist II

BC Forward is looking for Denial Specialist II (Remote Work)

Position Title: Denial Specialist II (Remote Work)

Locations: Remote-Oklahoma (Only Local to OK)

Anticipated Start Date: 6/3

Expected Duration: 6 months.

Job Type: Contract with possible extension

Pay Rate: $22.00/hr on W2.

Need: Must have Healthcare Insurance experience (Denials/Appeals).

Job Description:

Generates, processes and maintains provider and member correspondence for preservice and concurrent review.

Take calls from our internal call centre on complex authorization related issues, attach medical records, process member/provider letters and process authorization requests. Mainly computer based, provider-based work.

Describe the performance expectations/metrics for this individual and their team:
• Maintain good working relationship with other departments
• Team goal/state requirement: process 90% (or more) of authorizations and medical records within 24-72-hour turnaround time
• Team goal/state requirement: answer 95% of inbound calls, must answer within 30 seconds
• Individual goal: Process 45 tasks per day (combination of letters, calls, medical records, authorization building)
• Individual goal: Maintain monthly audit score of 90% or higher

Required Skills/Experience:
Customer Service
Medical Terminology Knowledge
Ability to Multitask
Ability to adapt to changing work task
Insurance Experience

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

Knowledge of denials process including understanding medical record information preferred.Generates correspondence from EMR documentation and ensures correspondence tasks are processed in a timely manner to ensure compliance according to regulatory standards and policies

Updates and maintains correspondence templates based on regulatory, and interdepartmental correspondence inquiries

Coordinates all data collection, analysis, and reporting activities that impact the denial process

Assists with the compliance and turn-around time (TAT) log for all correspondence notifications
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.

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 222464 when responding to this ad.