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Immediate Openings for AR caller(Only Life science Graduates) - Vee Technologies

1.00 to 3.00 Years   Chennai   24 May, 2024
Vee Healthtek Private Limited
Job LocationChennai
EducationNot Mentioned
SalaryRs 1.0 - 4.0 Lakh/Yr
IndustryMedical / Healthcare
Functional AreaPharmacist / Medical Representative
EmploymentTypeFull-time

Job Description

    Immediate Openings for AR caller(Only Life science Graduates) - Vee TechnologiesAny medical graduate/ RN. Prior experience working on Appeals/Denials, Strong Clinical knowledge with direct patient care experience- 1-5 years of allied experience in patient care.UR Timings: 6:30 PM IST- 3:30 AM IST - Mon-Friday / Full Time Hire.Roles & Responsibilities :--Roles and Responsibilities*1. *Census Monitoring:*- Check census in CPSI at the start, middle, and end of each shift to monitor patient flow and bed occupancy.2. *Communication and Coordination:*- Attend daily huddles to discuss patient care and operational issues.- Participate in Teams meetings to facilitate interdisciplinary collaboration.3. *Insurance and Authorization:*- Check authorization status for patient care services in insurance portals.- Request authorization for inpatient stays through the insurance portal.- Handle appeals and inquiries related to the appeals process through outbound calls.4. *Email and Call Management:*- Respond to emails from the retro group and other departments requiring clarification on patient cases.- Monitor Avaya for potential inbound calls, ensuring prompt response to inquiries or issues.- Make outbound calls to follow up on the statuses of pending appeals and inquiries.5. *Medical Necessity and Review:*- Review inpatient stay, continued stay, and observation cases for medical necessity using criteria from MCG or InterQual.- Arrange peer-to-peer reviews with medical directors whenever necessary.6. *Documentation and Data Management:*- Calculate inpatient and observation length of stay.- Note in the admission log the next review date and update stay type as needed.- Attach relevant documents such as MCG summaries, appeal forms, denials, and authorization letters in CPSI.7. *Physician Collaboration:*- Contact attending physicians if criteria for inpatient stay are not met and coordinate any necessary changes in stay type.8. *Denial Management:*- Review payment denials in the prior authorization worksheet.- File reconsiderations and appeals for denied admission cases.9. *Reporting and Analysis:*- Check the ER Log for possible admissions over the weekend to ensure all are accounted for.- Prepare quarterly reports on admissions for quality assurance and performance improvement.10. *Administrative Support:*- Fax discharge summaries upon request to ensure continuity of care post-dischargeInterested candidates reach out to Vanitha- hidden_email /hidden_mobile (Available in Whatsapp Also)RegardsVanitha - HRhidden_mobilehidden_emailVee Technologies

Keyskills :
appealsprior authorizationlife sciencesdenialsar callingpatient care

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