We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities.
We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
Grade 03
POSITION PURPOSE
Responds to provider requests telephonically and electronically for preauthorization of inpatient admissions and outpatient services and procedures.
Verification of benefits, eligibility and provider network status. Promotes and maintains a positive company image through telephonic and electronic contact with internal and external customers.
NATURE AND SCOPE
QUALIFICATIONS
Education
Work Experience
1 year call center experience or prior knowledge of a health insurance pre-service authorization required
Skills and Abilities
Licenses and Certifications
None Required
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Responds to provider requests telephonically and electronically for preauthorization of inpatient admissions and outpatient services and procedures.
Verifies benefits, eligibility and provider network status. Responsible for meeting targets for staff and unit performance as required by company and management standards to ensure achievement of departmental productivity goals
Receives member clinical data, enters relevant case information and follows departmental processes to authorize services as appropriate.
If processes do not allow approval, forwards cases and attached clinical data to the appropriate Utilization Review team.
Ensures authorizations are conducted in a manner that minimizes any disruption in the provision of healthcare, standardizes the timeliness of the decisions and maintains flexibility to accommodate providers’ / members’ needs to help ensure customer satisfaction
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job.
Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
LI SH1
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted.
To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors.
We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions.
As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus.
Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Last updated : 2024-05-21
Click the checkbox next to the jobs that you are interested in.
Click the checkbox next to the jobs that you are interested in.
Assessment and Diagnosis Skill
Behavioral Therapy Management Skill
Apollo Behavioral Health Hospital, Baton Rouge, LA
Admission Coordinator - Intake Department Alt weekends 6p - 6a
Apollo Behavioral Health Hospital, Baton Rouge, LA