Telehealth Medical Clearance Specialist

1 week ago

tumakuru, India beBeeAuthorization Full time

Job Title:Telehealth Medical Clearance SpecialistJob Summary:We are seeking a highly skilled Telehealth Medical Clearance Specialist to join our team. The ideal candidate will have excellent communication and analytical skills, with the ability to review and analyze patient medical records to determine the necessity of prior authorizations for various procedures and treatments.This role is responsible for communicating effectively with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests in a timely manner. The specialist must also maintain accurate documentation of all authorization requests, approvals, and denials in compliance with HIPAA regulations.The successful candidate will be able to follow up on pending authorizations and resolve any issues that may arise during the approval process. They will also stay updated on changes in insurance policies, managed care requirements, and relevant medical coding practices (ICD-10).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 authorizations for sleep studies in-lab and home sleep studies.Process sleep consultations authorizations.Manage the sleep study appeals process.Referral process for oral appliance therapy.Required Skills and Qualifications:To succeed in this role, you should possess excellent communication and analytical skills, with the ability to work in a fast-paced environment and prioritize multiple tasks. A bachelor's degree in a related field and relevant experience are preferred.Benefits:This is a full-time position offering a competitive salary, comprehensive benefits package, and opportunities for professional growth and development.Others:We are an equal opportunity employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional patient care, we encourage you to apply for this exciting opportunity.

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