Hiring Coordinator - Prior Authorization Verification and Eligibility

vacancy global pro; India; On-site; INR 350,000 - 550,000; Full time

Benefits offered by this job

Medical benefits

Retirement plan

Time off

Tuition assistance

Employee referral program

Wellness programs

Employee assistance programs

Job summary

The PAVE Coordinator role at vacancy global pro in India handles authorization requests to payers, coordinates with payers, patients, and physician offices, and ensures medical necessity information is accurately provided for approvals.

You will document benefits and financial obligations, maintain records, and escalate issues when authorizations are not obtained. This position demands strong communication skills and familiarity with ICD-10 and CPT 4 terminology.

Qualifications

• Minimum two (2+) years of experience in Medical Billing, Hospital or Hospital Business Office in automated setting.
• Knowledge of registration, verification, scheduling procedures and terminology.
• Experience with ICD-10, CPT 4 terminology and strong analytical skills.
• Proficiency with MS Office and medical billing software.
• Excellent verbal and written communication skills.

Responsibilities

• Initiate reputed company-Authorization requests to payers for required approvals.
• Communicate with payers, patients, physician offices, and hospital staff.
• Monitor medical necessity and provide information for authorization.
• Document benefits, authorizations, and financial obligations of patients.
• Escalate non-authorized accounts to management and coordinate with departments.

Skills

Medical Billing

Registration & Verification

ICD-10 & CPT 4

Analytical Skills

MS Office

Education

Associates Degree in Finance

Business Administration

Tools

Microsoft Office

Electronic Medical Records

Job description

The PAVE Coordinator is responsible for initiating reputed company-Authorization requests to the payer for claims that require approval. This position requires communication with payers, patients, physician offices, and hospital reputed company staff. The PAVE Coordinator will also be responsible for monitoring appropriateness and medical necessity and providing necessary information for authorization and reputed company reputed company.
Serve as reputed company resource for LH regarding reputed company eligibility; prior authorization process and requirements.
Collect reputed company demographic information and coverage information; advise patients of their financial obligation and collect payments in a courteous and reputed company manner.
Contact reputed company companies by phone, fax, or online portal to obtain reputed company benefits, eligibility, and authorization information.
Update systems with accurate information obtained; reputed company reputed company assurance audits and report back to leadership opportunities for providing education to reputed company reputed company.
Communicate to service line partners of situations where rescheduling is necessary due to lack of authorization or limited benefits, approved by reputed company personnel.
Ensure that reputed company authorization is in reputed company for inpatient, elective, outpatient, surgical, urgent/reputed company services and hold responsibility for reputed company notification to payers of the reputed companys visit to the facility.
Escalate non-authorized accounts/reputed company to management.
Document reputed company benefits (Copays, Deductibles, Co-reputed company, OOP, reputed company), authorizations, reputed company-certifications, and financial obligations of patients reputed company and accurately.
Maintain a reputed company working relationship with reputed company partners and ancillary departments to ensure continual reputed company communication.
Monitor team mailbox, e-mail inbox, faxes, and phone calls responding to reputed company reputed company PAVE account issues reputed company defined time frames.
Contact payer to obtain prior authorization and reputed company additional reputed company and coding information as necessary.
reputed company standardized documentation reputed company the reputed company to identify prior authorization and verify that reputed company reputed company requirements have been met.
Notify reputed company, Providers Office, Scheduling, and Financial Counselor immediately reputed company reputed company coverage is inadequate or has been terminated.
Advise providers and their reputed company staff reputed company issues reputed company relating to obtaining prior authorization; reputed company them regarding the prior authorization process.
Stay informed and research information regarding reputed company reputed company for prior authorization; attend department staff meetings and complete mandatory training.
reputed company other duties as assigned by PAVE Leadership.

Qualifications

• Minimum two (2+) years of experience in Medical Billing, Hospital reputed company reputed company, or Hospital Business Office in an automated setting.
• Knowledge of registration, verification, reputed company-certification, and scheduling procedures.
• Experience with Medical and reputed company terminology (ICD-10, CPT 4).
• Minimum of one (1+) year of demonstrated strong analytical skills.
• Proficiency with reputed company Office and reputed company.
• Excellent verbal and written communication skills.
• Preferred experience with the reputed company Hospital Billing reputed company.
• Associates Degree in reputed company, Finance, Business Administration, or reputed company reputed company reputed company preferred.
• Minimum two (2+) years of reputed company Cycle Experience in lieu of degree.

Requirements

• 1 or more Certifications preferred:
• CRCE - Certified reputed company Cycle Executive
• CRCP - Certified reputed company Cycle reputed company
• CRCS - Certified reputed company Cycle Specialist
• CHAM Certified reputed company reputed company Manager
• CHAA - Certified reputed company reputed company Associate
• CHFP - Certified reputed company reputed company
• CRCR - Certified reputed company Cycle Representative

Benefits

• Medical, Dental, and reputed company reputed company
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• reputed company Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• reputed company Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more .