Care Coordination Specialist

2 weeks ago


nagpur, India beBeeAuthorization Full time

Telehealth Prior Authorization CoordinatorWe are seeking a detail-oriented and organized Telehealth Prior Authorization Coordinator to empower our patients with timely care.This individual must review and analyze patient medical records to determine the necessity of prior authorizations for various procedures and treatments.The ideal candidate will effectively communicate with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests.Accurate documentation of all authorization requests, approvals, and denials is crucial in compliance with HIPAA regulations.Key Responsibilities:Patient Medical Record Analysis: Review and analyze patient medical records to determine the necessity of prior authorizations.Authorization Request Submission: Communicate effectively with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests.Documentation and Compliance: Maintain accurate documentation of all authorization requests, approvals, and denials in compliance with HIPAA regulations.Follow-up and Issue Resolution: Follow up on pending authorizations and resolve any issues that may arise during the approval process.Insurance Policy Updates: Stay updated on changes in insurance policies, managed care requirements, and relevant medical coding practices (ICD-10).Collaboration and Patient Education: 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.Sleep Study Authorizations: Process sleep study authorizations for in-lab and home sleep studies.Sleep Consultations and Appeals: Manage sleep consultations authorizations and the sleep study appeals process.Oral Appliance Referrals: Handle oral appliance referral processing.In this role, you will play a critical part in ensuring our patients receive timely care while maintaining accurate and compliant documentation.


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