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

Role : Process Associate

Industry Type : Call Centre / BPO / KPO / ITES / LPO

Gender : Male

Job Country : India