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