Coordinator - PAVE

The role

The PAVE Coordinator initiates pre-authorization requests to payers for claims requiring approval. This role involves communicating with payers, patients, physician offices, and hospital clinical staff to manage pre-certifications and medical necessity.

What you will do

• Serve as primary resource for insurance eligibility and prior authorization process
• Collect patient demographic and coverage information
• Advise patients of financial obligations and collect payments
• Contact insurance companies via phone, fax, or online portal for benefits and authorization
• Update systems with accurate information and perform quality assurance audits
• Communicate rescheduling needs to service line partners due to lack of authorization
• Ensure proper authorization for inpatient, elective, outpatient, surgical, and urgent/emergent services
• Document all benefits, authorizations, and financial obligations on accounts
• Maintain working relationships with clinical, ancillary, and surgical scheduling departments
• Monitor team mailbox, email, faxes, and phone calls

Required qualifications

• Minimum two (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 of one (1+) year of demonstrated strong analytical skills
• Proficiency with Microsoft Office and Outlook
• Excellent verbal and written communication skills
• Minimum two (2+) years of Revenue Cycle Experience in lieu of degree

Nice to have

• Experience with the Epic Hospital Billing System
• Associates Degree Accounting, Finance, Business Administration or Healthcare related field
• CRCE - Certified Revenue Cycle Executive
• CRCP- Certified Revenue Cycle Professional
• CRCS- Certified Revenue Cycle Specialist
• CHAM – Certified Healthcare Access Manager
• CHAA- Certified Healthcare Access Associate
• CHFP- Certified Healthcare Financial Professional
• CRCR- Certified Revenue Cycle Representative

Benefits

• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs

About the company

Luminis Health is the employer for this position at Anne Arundel Medical Center.