Coordinator - PAVE

About Our Client:The organization operates within the healthcare industry, focusing on medical billing, patient access, and revenue cycle management within a hospital setting. It addresses challenges related to insurance eligibility, pre-authorization processes, and financial clearance to ensure smooth patient service and financial operations. About the Opportunity:The COORDINATOR, PRE-AUTHORIZATION VERIFICATION & ELIGIBILITY (PAVE) plays a crucial role in managing pre-authorization requests and verifying insurance eligibility for medical procedures. This position supports the organization by ensuring necessary approvals are obtained timely, helping to maintain financial integrity and patient access to care. Responsibilities:Initiate pre-authorization requests with payers for required claims.Communicate with payers, patients, physician offices, and clinical staff.Pre-certify physician-ordered procedures.Monitor appropriateness and medical necessity for authorizations.Confirm or obtain pre-certifications and conduct quality assurance.Serve as primary resource for insurance eligibility and prior authorization information.Collect patient demographics and coverage details; advise patients on financial obligations and collect payments.Contact insurance companies to verify benefits, eligibility, and authorizations.Update systems accurately and perform quality audits, reporting findings.Notify service line partners of necessary rescheduling due to authorization issues.Ensure authorization for various service types and timely payer notifications.Document patient financial obligations clearly to facilitate account processing.Maintain communication with clinical and ancillary departments to support authorization processes.Monitor communications related to PAVE accounts and respond within set time frames.Obtain additional clinical or coding information as needed for authorizations.Provide standardized documentation of prior authorizations and verify insurance requirements.Notify relevant parties immediately when insurance coverage is inadequate.Educate providers and clinical staff on prior authorization issues and processes.Stay informed on insurance criteria and participate in relevant trainings.Perform other duties as assigned by PAVE leadership. Requirements:Minimum two years of experience in medical billing, patient access, or hospital business office in an automated environment.Knowledge of registration, verification, pre-certification, and scheduling procedures.Familiarity with medical and insurance terminology (ICD-10, CPT-4).At least one year demonstrating strong analytical skills.Proficiency in Microsoft Office and Outlook.Excellent verbal and written communication skills.Preferred experience with the Epic Hospital Billing System.Associate degree in accounting, finance, business administration, or healthcare-related field preferred; alternatively, two years of revenue cycle experience.Preferred certifications include CRCE, CRCP, CRCS, CHAM, CHAA, CHFP, or CRCR. Pay Range and Compensation Package:Pay range for this role is $17.50 to $26.00 USD per hour. Benefits & Perks:Medical insuranceDental insurance Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.