Business Analyst II
shift: First
work hours: 9 AM - 5 PM
education: High School Responsibilities Position Summary: Process medical referrals and prior authorizations specifically for total joint and total hip procedures. Manage inbound inquiries, investigate complex authorization requests, and ensure complete compliance with insurance guidelines and record standards. Key Responsibilities:
- Initiate, process, and track prior authorizations and referrals for specialized joint and hip surgeries.
- Manage a high-volume inbound phone queue to assist patients, physicians, and clinical staff with status inquiries.
- Investigate and resolve complex, multi-layered authorization requests in accordance with insurance standards.
- Accurately log all interactions, statuses, and clinical details within designated electronic medical record (EMR) systems.
- High School Diploma or GED required.
- 4+ years of administrative experience working in a healthcare setting.
- Strong knowledge of medical terminology, with heavy emphasis on orthopedics, total joint, and total hip procedures.
- Excellent customer service, time management, and queue-management skills.
- Proficiency in Microsoft Office Suite.
- Preferred: Direct operational experience with Epic EMR software.
- Call Center
- Benefits Administration
- Business Analysis
- Business operations
- SMALL BUSINESS LENDING
- Years of experience: 2 years
- Experience level: Experienced
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected]. Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility). This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
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