Process Associate

Intelligent Medical Billing Solution

WE ARE HIRING!!!

We have urgent openings in RCM (Revenue Cycle Management) Dept.

Immediate joiners are most welcome and with at least 1 to 3 years of relevant experience.

Candidates with good interpersonal skills are the most desirable.

Objective: To obtain prior authorizations for all procedural orders by completing the authorization process with all commercial payers.

Position: Pre-Authorization Coordinator Location: Ahmedabad, India (Office based)

Type of Work: Full time, permanent Work Hours: Monday to Friday, Night Shift

The role and responsibilities: The Pre-Authorization Coordinator is responsible for obtaining and coordinating all pre-authorization or pre certification per payer requirements requested by the medical providers.

The Information obtained by insurance companies and/or third-party representatives for services requested are documented in appropriate systems or software to ensure proper communication and coordination.

● Determine patient's eligibility for insurance benefits prior to medical treatments and tests.

● Secure necessary pre-authorizations.

● Confirm accuracy of CPT and ICD-10 diagnoses 4

● Review chart documentation to ensure patient meets medical policy guidelines

● Verify coverage and communicate with medical facilities to resolve any discrepancies.

● Maintain logs of denied claims and problem-solving cases as needed.

● Follow-up on missing or inaccurate information and coordination with clinical staff and physicians.

● Prioritize incoming authorization requests according to the urgency

● Maintain individual payer files to include up to date requirements needed to successfully obtain

authorizations

●Requirements:

● Must have sound knowledge of claims, and ICD-10 and CPT codes

● Knowledge of procedure authorization and its impact on the revenue cycle

● Good understanding of payer medical policy guidelines

● Conflict resolution

● Strong written and verbal communication skills.

• Experience

  0 - 2 Years

• No. of Openings

  15

• Education

  Higher Secondary, M.A, M.Com, MD/Medicine Doctor, M.Pharma, M.Sc, Any Bachelor Degree, Professional Degree, Post Graduate Diploma

• Role

  Process Associate

• Industry Type

  Call Centre / BPO / KPO / ITES / LPO

• Gender

  Male

• Job Country

  India

• Type of Job

  Full Time

• Work Location Type

  Work from Office