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[Hiring] Prior Authorization Specialist @BMC Company 100 ID-14257

Role Description

Responsible for screening prior-authorization and coordination of specialized services requests in the medical care management program, including a broad range of requests for inpatient, outpatient and ancillary services.

Qualifications

  • High school diploma or GED required; Associate’s Degree or higher preferred.
  • 4-5 years of office experience in a high volume data entry office, customer service call center, or healthcare office.
  • Experience using insurance payer websites (e.g., Blue Cross Blue Shield, Medicare).
  • Customer service experience preferred.
  • Experience with insurance verification, prior authorization, pre-certification, and financial clearance process.

Requirements

  • Bilingual preferred.
  • Ability to process a high volume of requests with a 95% or greater accuracy rate.
  • Ability to prioritize workload when processing referrals and authorization requests per guidelines.
  • Effective collaboration skills.
  • Strong oral and written communication skills.
  • Thorough knowledge of financial clearance process is a must.
  • Familiarity with insurances, referral authorizations, and third-party billing procedures.
  • Knowledge of basic medical terminology and ICD-9/CPT coding is helpful.
  • Excellent interpersonal skills to build and maintain strong relationships.
  • Self-directed and highly organized with the ability to multitask.
  • Requires ability to make independent decisions under pressure.
  • Must maintain confidentiality of all personal/health sensitive information.
  • Knowledge of and experience within Epic is preferred.
  • Basic computer proficiency, including Microsoft Suite applications.

Benefits

  • Opportunity to make a difference as part of our mission to provide exceptional and equitable care.
  • Recognized as a top employer and best place to work.
  • Strong sense of teamwork and support for staff.
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1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

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This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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