Coordinator - Prior Authorization Verification and Eligibility
New
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Luminis HealthHealthcare Revenue Cycle
Only available in MD, PA, Washington DC, WV, VA, TN, TX, NC, SC, GA, FLFull-TimeMiddle
Salary17.5 - 26 USD per hour
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Job Details
- Experience
- Minimum two (2+) years of experience in Medical Billing, Hospital Patient Access, or Hospital Business Office in an automated setting.
- Required Skills
- Microsoft Office
Requirements
- Minimum 2 years of experience in Medical Billing, Hospital Patient Access, or Hospital Business Office in an automated setting.
- Knowledge of registration, verification, pre-certification, and scheduling procedures.
- Experience with medical and insurance terminology (ICD-10, CPT 4).
- Minimum 1 year of demonstrated strong analytical skills.
- Proficiency with Microsoft Office and Outlook.
- Excellent verbal and written communication skills.
- Associate degree in Accounting, Finance, Business Administration, or Healthcare-related field preferred.
- 2 years of revenue cycle experience in lieu of a degree.
- Preferred certifications include CRCE, CRCP, CRCS, CHAM, CHAA, CHFP, or CRCR.
Responsibilities
- Serve as the primary resource for insurance eligibility and prior authorization requirements.
- Contact payers via phone, fax, or portal to obtain benefits, eligibility, and authorization information.
- Ensure proper authorization for inpatient, elective, outpatient, and surgical services.
- Document insurance benefits, copays, and deductibles accurately in the system.
- Collaborate with clinical partners, Case Management, and Utilization Review to facilitate clinical documentation submission.
- Notify patients and providers of inadequate or terminated coverage.
- Perform quality assurance audits and provide feedback to improve patient access processes.
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