Patient Care Agent – Blended Account
Posted 3 days ago
You'll complete your application on Neolytix's career site.
About the Role
In this hybrid position, you will act as a vital contributor to a group assisting private medical providers with administrative tasks and revenue cycle improvements. Your work centers on overseeing the authorization process and offering crucial aid to both clinical personnel and patients. By maintaining accuracy in medical billing and authorization workflows, you allow doctors to focus on delivering superior medical care. This role takes place in a fast-paced, multi-queue setting where your contributions directly influence the smooth operation of clinical practices. You will act as a primary communication liaison, blending administrative duties with professional outreach to facilitate efficient business operations.
Requirements
- You should possess previous experience managing authorization lifecycles, whether acquired in a medical BPO, hospital, outpatient clinic, or revenue cycle division.
- Direct, practical experience working with prior authorization workflows is necessary, specifically concerning portal submissions, tracking escalations, and navigating intricate appeals.
- You are required to be proficient with EHR and EMR platforms and must be capable of verifying and gathering clinical documentation with high accuracy.
- Strong organizational capabilities are needed to handle large-scale, multi-queue responsibilities while meeting established service level agreements.
- You must exhibit high-level communication abilities to manage phone interactions with healthcare providers and insurance members.
- Finally, you must demonstrate a dedication to protecting patient privacy and must successfully complete all mandated security and HIPAA training.
Responsibilities
- You will oversee the complete authorization process, starting from the initial application until the final outcome is reached.
- Your daily tasks include sending requests via authorized insurance channels, monitoring current progress, and managing follow-up actions or escalations to adhere to strict timelines.
- It is your duty to gather and confirm clinical records while providing assistance for peer-to-peer reviews, rejected claims, and appeals.
- Furthermore, you will manage incoming inquiries from medical staff and clinicians, in addition to helping insurance plan members with questions regarding their accounts, coverage, and billing.
- Precise record-keeping is required through exact data entry and thorough logging of every communication, ensuring that all files are kept professional and prepared for potential audits.
Note: This listing is summarized and paraphrased by WorkNow from a publicly posted role. For the original wording and full details, please refer to the employer's official posting.
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