Medical Care Coordinator

1 week ago

kozhikode, India beBeeAuthorization Full time

Telehealth Prior Authorization Coordinator Job DescriptionThis role plays a vital part in ensuring timely patient care by coordinating the prior authorization process for various medical procedures and treatments.As a Telehealth Prior Authorization Coordinator, you will be responsible for reviewing patient medical records, communicating with healthcare providers and insurance companies, and maintaining accurate documentation of all authorization requests.Key Responsibilities:Review and analyze patient medical records to determine the necessity of prior authorizations for various procedures and treatments.Communicate effectively with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests.Maintain accurate documentation of all authorization requests, approvals, and denials in compliance with HIPAA regulations.Follow up on pending authorizations and resolve any issues that may arise during the approval process.Stay updated on changes in insurance policies, managed care requirements, and relevant medical coding practices (ICD-10).Collaborate with medical office staff to ensure seamless patient care and efficient processing of authorizations.Educate patients on the prior authorization process and any necessary steps they need to take.Process sleep study authorizations, including lab and home studies.Manage sleep consultations and appeals processes.Referral Process For Oral AppliancesRequirements and QualificationsThe ideal candidate has experience in outpatient practice, multispecialty practice, and proficiency in EPIC EMR. They enjoy working with people, have excellent communication skills, and are well-organized.Required Skills:Excellent analytical and problem-solving skills.Strong communication and interpersonal skills.Ability to work in a fast-paced environment.Proficiency in electronic medical records (EMRs) systems, specifically EPIC.Knowledge of HIPAA regulations and compliance.Basic understanding of medical coding practices (ICD-10).Attention to detail and accuracy.

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