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Luminis Health

Remote Jobs

7 open rolesTeam 5001-10000Latest: May 11, 2026, 4:23 PM UTC
Hospitals and Health Care
Post Date
Minimum Salary
Experience

7 Jobs

Full TimeRemoteSeniorTeam 5,001-10,000

Role Description The Sr. PAVE Coordinator is responsible for initiating Pre-Authorization requests to the payer for claims that require approval. This position requires communication with payers, patients, physician offices, and hospital clinical staff. The Sr. PAVE Coordinator will also be responsible for monitoring appropriateness and medical necessity and providing necessary information for authorization and continued visits. - Serve as primary resource for LH regarding insurance eligibility and prior authorization process. - Collect patient demographic and coverage information; advise patients of their financial obligations. - Contact insurance companies to obtain benefits, eligibility, and authorization information. - Update systems with accurate information; perform quality assurance audits. - Communicate with service line partners regarding rescheduling due to lack of authorization. - Ensure proper authorization for various services and notify payers timely. - Document all benefits, authorizations, and financial obligations clearly and accurately. - Maintain a close working relationship with clinical partners and ancillary departments. - Monitor team mailbox, e-mail inbox, faxes, and phone calls for PAVE account issues. - Contact payers to obtain prior authorization and gather additional information as necessary. - Provide standardized documentation within the system for prior authorization. - Advise providers and their clinical staff on prior authorization issues. - Stay informed about insurance criteria for prior authorization. - Attend department meetings and complete mandatory training. - Perform other duties as assigned by PAVE Leadership. Qualifications - Minimum three (3+) years of experience in Medical Billing, Hospital Patient Access, or Hospital Business Office. - 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. - Preferred experience with the Epic Hospital Billing System. - Bachelor’s Degree in Accounting, Finance, Business Administration, or Healthcare related field preferred. - Minimum three (3+) years of Revenue Cycle Experience in lieu of degree. Requirements - One (1+) or more certifications from AAHAM, NAHAM, or HFMA required. - Healthcare Certification. - 1 or more Certifications required: - 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 and more

United States
$19 - $28 / hour
Full TimeRemoteMid LevelTeam 5,001-10,000

Role Description The Inpatient Medical Coder under the supervision of the Manager of Coding and Data Quality accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. - Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for reimbursement, research, and compliance with federal and state regulations. - Utilizes critical thinking to analyze and evaluate documentation issues with consultation from medical and clinical staff, and clinical documentation specialists as needed. - Monitors assigned work on a daily basis to facilitate the billing process within established timeframes. - Maintains a high level of accuracy in code assignments to prevent claim denials, billing errors, and potential legal issues. - Reviews medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignments. - Communicates with various departments within the hospitals regarding billing and registration issues. - Complies with AHIMA standards of ethical coding and coding compliance guidelines, including adherence to HIPAA privacy regulations. - Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignments. - Participates in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials. - Performs other duties or projects such as coding corrections assigned by the manager. Qualifications - High School graduate or equivalent. - Formal ICD-10-CM and CPT training required. - Associates or Bachelor’s degree preferred. - At least two (2) years of inpatient ICD-10-CM/ICD-10-PCS coding and abstracting experience in an acute care hospital setting required. - Experience with assignment, MS-DRG/APR-DRG methodologies, and inpatient reimbursement guidelines preferred. - Certification as Certified Coding Specialist (CCS) required. - Preferred Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA). Requirements - Strong analytical and organizational skills. - Ability to prioritize workloads and meet deadlines. - Excellent customer service skills. - Ability to problem solve and work with minimal supervision. - Familiar with basic medical terminology. - Computer experience and typing ability. 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 and more.

United States
$26 - $39 / hour
Full TimeRemoteMid LevelTeam 5,001-10,000

Role Description Under the direction of the System Director of Performance Improvement, this position is responsible for supporting Luminis Health’s System-wide Performance Improvement Integration and Project Management initiatives by ensuring strategies are implemented and principles/practices are incorporated in the processes under transformation. This position implements and supports actions, at a System level (LHAAMC, LHDCMC, LHSS, McNew, LHCE) and/or site-level, that bring about improvements which may include, but are not limited to key strategic priorities identified by Executive Leadership and/or the Annual Operating Priorities, quality improvement, revenue cycle/profitability, recruitment, retention, and productivity, supply chain management, and downtime. - Support the System Director of Performance Improvement, Steering Committee, and Executive Leadership Team in implementing a vision that affects positive changes in patient care and key strategic operational priorities. - Implement tactical strategies to achieve the desired vision, executing long- and short-term objectives to support the value streams goals. - Work with system and site personnel to identify, address, and eliminate process-related obstacles/waste. - Assist in the change of systems/processes, as required, in support of the Lean initiatives. - Act as a change agent to bring about improvements in patient care processes through project management. - Facilitate or co-facilitate System and Site-specific Annual Strategic Priority setting and Deployment retreats as needed. - Support and/or design and execute event planning and perform necessary preparation. - Participate in, co-facilitate, or facilitate projects, events, and “just do-its.” - Participate in Gemba walks and coach employees. - Mentor LH Lean Six Sigma Program Green Belts. - Provide necessary training specific to Lean Transformation tools and methodology. - Follow up on action plans and assist all teams as needed to ensure improvements are made and sustained. - Support the launch of all activities needed to incorporate a culture of continuous improvement and “Systemness.” - Facilitate or co-facilitate Green Belt training program and identify ongoing training needs. - Support communication of the direction of Lean Transformation initiatives to all employees across the Health System. - Track all changes/improvements made to provide Executive Leadership/Management assurance that changes are effective and lasting. - Examine and evaluate the areas after improvements are implemented. - Post/update results to the Mission Control Center boards. - Review new procedures/controls and appraise the efficiency and effectiveness of operations. - Work with the System Director of Performance Improvement, Executive Leadership, Directors, Department Managers, and Supervisors to resolve any issues that might arise during implementation and/or maintenance phases. - Other duties as identified by the System Director of Performance Improvement to further the Lean Transformation initiatives and Integration efforts. Qualifications - Bachelor of Science Degree or related discipline required; Masters preferred. - Experience working in a world-class Lean working environment highly preferred. - Knowledge of basic PDSA, Lean concepts, continuous improvement-based tools and techniques, and project management methodologies required. - Proficient in Microsoft Office Suite. - Project Management experience and/or knowledge of project management tools preferred. Requirements - Six Sigma Greenbelt, Blackbelt, and PMP preferred. Working Conditions, Equipment, Physical Demands - There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens. - Physical Demands – Medium: Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. - The physical demands and work environment described are representative of those an employee encounters while performing the essential functions of this position. - Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. 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 and more Pay Range $72,508.80 — $148,387.20 USD

United States
$72.5K - $148.4K / year
Full TimeRemoteLeadTeam 5,001-10,000

Role Description The Medical Lead Coder under the supervision of the Manager of Coding and Data Quality assists with oversight of daily Inpatient coding operations in accordance with Luminis Health coding guidelines, ICD-10-CM Official Coding Guidelines for Coding and reporting, and other authoritative resources. This position may include: - Reviewing Inpatient medical records to extract pertinent information for code assignment. - Assigning principal and significant secondary ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes. - Ensuring compliance with coding guidelines, conventions, and regulatory requirements, including HIPAA. - Utilizing coding references, software tools, and electronic health records (EHR) for accurate code assignment. - Maintaining a high level of accuracy in code assignment to prevent claim denials and billing errors. - Staying updated with coding changes, industry trends, and regulatory updates. - Collaborating with healthcare providers and billing staff to clarify documentation and resolve coding-related queries. - Participating in ongoing education, training, and certification programs. - Upholding professional ethics, integrity, and confidentiality in handling patient information. - Conducting regular audits and quality assurance reviews to monitor coding accuracy. - Generating reports and providing coding-related data analysis to support healthcare management. - Assisting in the development and implementation of coding policies and procedures. - Providing support during external coding audits. - Maintaining a positive and collaborative working relationship with stakeholders. Qualifications - High School diploma or equivalent and Medical Coding Education. - Preferred: Bachelor’s degree in health information management, business administration, or related field. - Three (3) years of verifiable, progressive coding experience. - Preferred: More than five (5) years of coding experience in an acute care hospital setting. - Certification as a Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P), or a Certified Coding Associate (CCA) required. - Preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA). Requirements - Light work, exerting up to twenty pounds of force occasionally. - Reasonable expectation of no exposure to blood-borne pathogens. 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 and more.

United States
$26 - $39 / hour
OtherRemoteMid LevelTeam 5,001-10,000

Anne Arundel Medical Center Title: Coordinator, Pre-Authorization Verification & Eligibility (PAVE) Department: PAVE Reports To: Supervisor - PAVE Cost Center/Job Code: 10000-50133-000723 FLSA Status: Non - Exempt Position Objective: The PAVE Coordinator is responsible for initiating Pre-Authorization request to the payer for the claims that require approval. This position require communication with payers, patients, physician offices and hospital clinical staff. This position is primarily responsible for pre-certifying procedures ordered by physicians. The PAVE Coordinator will also be responsible monitoring appropriateness and medical necessity and provides necessary information for authorization and continued visits. This individual will confirm pre-certifications that have been obtained or will obtain pre-certifications if needed in addition to conducting quality assurance. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Serve as primary resource for LH regarding insurance eligibility; prior authorization process and requirements; collects patient demographic information and coverage information. Advises patients of their financial obligation and collects payments in a courteous and professional manner. - Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information; - Updates systems with accurate information obtained; performs quality assurance audits and reports back to leadership opportunities for providing education to patient access - Responsible for communicating to service line partners of situations where rescheduling is necessary, due to lack of authorization or limited benefits and is approved by clinical personnel; - Ensures that proper authorization is in place for inpatient, elective, outpatient, surgical, urgent/emergent services and held responsible for timely notification to payers of the patient’s visit to the facility to protect financial standing of the organization. Escalates non-authorized accounts/visits to management; - Ensures all benefits (Copays, Deductibles, Co-Insurance, OOP, LTM), authorizations, pre-certifications, and financial obligations of patients, are documented on account, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts and denial prevention.; - Maintains a close working relationship with clinical partners, and ancillary departments to ensure continual open communication between clinical, ancillary, and Patient Access & Patient Financial Services, Surgical Scheduling departments. Case Management, and Utilization Review to facilitate the sending of clinical information in support of the authorization to the payer, as assigned; - Monitors team mailbox, e-mail inbox, faxes, and phone calls responding to all related PAVE account issues, within defined time frames; Adheres to the department accuracy and performance standards. - Contact payer to obtain prior authorization. Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization; 10. Provide standardized documentation within system to identify prior authorization and the criteria surrounding such authorization; Verify that all insurance requirements have been met; Notify patient, Provider’s Office, Scheduling and Financial Counselor immediately when insurance coverage is inadequate or has been terminated. 11. Advises providers and their clinical staff when issues arise relating to obtaining prior authorization; educate providers and their clinical staff regarding the prior authorization process. 12. Stay informed and research information regarding insurance criteria for prior authorization; Attend department staff meetings, professional education sessions, complete e-learnings and mandatory training. 13. Performs other duties as assigned by PAVE Leadership. Educational/Experience Requirements: - 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. - Preferred experience with the Epic Hospital Billing System - Associates Degree Accounting, Finance, Business Administration or Healthcare related field preferred - Minimum two (2+) years of Revenue Cycle Experience in lieu of degree Required License/Certifications: - 1 or more Certifications preferred: - 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 Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens. Physical Demands - The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary. Pay Range $17.50—$26 USD Luminis Health Benefits Overview: • 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 and more *Benefit offerings based on employment status Opt-in for text notifications! Luminis Health's two-way SMS texting platform lets you receive notifications and messages from our Talent Acquisition team directly on your phone. To enable this feature, select "yes" when asked to "opt-in to receive text messages" and to "Receive updates from a recruiter about this job via SMS" when completing your application. Once you are opted in, you can easily opt-out at any time. Standard text messaging rates may apply based on the candidate's mobile carrier plan. Luminis Health is not responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage charges.

United States
$18 - $26 / hour
OtherRemoteMid LevelTeam 5,001-10,000

Anne Arundel Medical Center Title: Coordinator, Pre-Authorization Verification & Eligibility (PAVE) Department: PAVE Reports To: Supervisor - PAVE Cost Center/Job Code: 10000-50133-000723 FLSA Status: Non - Exempt Position Objective: The PAVE Coordinator is responsible for initiating Pre-Authorization request to the payer for the claims that require approval. This position require communication with payers, patients, physician offices and hospital clinical staff. This position is primarily responsible for pre-certifying procedures ordered by physicians. The PAVE Coordinator will also be responsible monitoring appropriateness and medical necessity and provides necessary information for authorization and continued visits. This individual will confirm pre-certifications that have been obtained or will obtain pre-certifications if needed in addition to conducting quality assurance. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Serve as primary resource for LH regarding insurance eligibility; prior authorization process and requirements; collects patient demographic information and coverage information. Advises patients of their financial obligation and collects payments in a courteous and professional manner. - Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information; - Updates systems with accurate information obtained; performs quality assurance audits and reports back to leadership opportunities for providing education to patient access - Responsible for communicating to service line partners of situations where rescheduling is necessary, due to lack of authorization or limited benefits and is approved by clinical personnel; - Ensures that proper authorization is in place for inpatient, elective, outpatient, surgical, urgent/emergent services and held responsible for timely notification to payers of the patient’s visit to the facility to protect financial standing of the organization. Escalates non-authorized accounts/visits to management; - Ensures all benefits (Copays, Deductibles, Co-Insurance, OOP, LTM), authorizations, pre-certifications, and financial obligations of patients, are documented on account, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts and denial prevention.; - Maintains a close working relationship with clinical partners, and ancillary departments to ensure continual open communication between clinical, ancillary, and Patient Access & Patient Financial Services, Surgical Scheduling departments. Case Management, and Utilization Review to facilitate the sending of clinical information in support of the authorization to the payer, as assigned; - Monitors team mailbox, e-mail inbox, faxes, and phone calls responding to all related PAVE account issues, within defined time frames; Adheres to the department accuracy and performance standards. - Contact payer to obtain prior authorization. Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization; 10. Provide standardized documentation within system to identify prior authorization and the criteria surrounding such authorization; Verify that all insurance requirements have been met; Notify patient, Provider’s Office, Scheduling and Financial Counselor immediately when insurance coverage is inadequate or has been terminated. 11. Advises providers and their clinical staff when issues arise relating to obtaining prior authorization; educate providers and their clinical staff regarding the prior authorization process. 12. Stay informed and research information regarding insurance criteria for prior authorization; Attend department staff meetings, professional education sessions, complete e-learnings and mandatory training. 13. Performs other duties as assigned by PAVE Leadership. Educational/Experience Requirements: - 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. - Preferred experience with the Epic Hospital Billing System - Associates Degree Accounting, Finance, Business Administration or Healthcare related field preferred - Minimum two (2+) years of Revenue Cycle Experience in lieu of degree Required License/Certifications: - 1 or more Certifications preferred: - 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 Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens. Physical Demands - The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary. Pay Range $17.50—$26 USD Luminis Health Benefits Overview: • 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 and more *Benefit offerings based on employment status Opt-in for text notifications! Luminis Health's two-way SMS texting platform lets you receive notifications and messages from our Talent Acquisition team directly on your phone. To enable this feature, select "yes" when asked to "opt-in to receive text messages" and to "Receive updates from a recruiter about this job via SMS" when completing your application. Once you are opted in, you can easily opt-out at any time. Standard text messaging rates may apply based on the candidate's mobile carrier plan. Luminis Health is not responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage charges.

United States
$18 - $26 / hour
Job Closed
OtherRemoteTeam 5,001-10,000

Anne Arundel Medical Center Title: Coordinator, Pre-Authorization Verification & Eligibility (PAVE) Department: PAVE Reports To: Supervisor - PAVE Cost Center/Job Code: 10000-50133-000723 FLSA Status: Non - Exempt Position Objective: The PAVE Coordinator is responsible for initiating Pre-Authorization request to the payer for the claims that require approval. This position require communication with payers, patients, physician offices and hospital clinical staff. This position is primarily responsible for pre-certifying procedures ordered by physicians. The PAVE Coordinator will also be responsible monitoring appropriateness and medical necessity and provides necessary information for authorization and continued visits. This individual will confirm pre-certifications that have been obtained or will obtain pre-certifications if needed in addition to conducting quality assurance. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Serve as primary resource for LH regarding insurance eligibility; prior authorization process and requirements; collects patient demographic information and coverage information. Advises patients of their financial obligation and collects payments in a courteous and professional manner. - Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information; - Updates systems with accurate information obtained; performs quality assurance audits and reports back to leadership opportunities for providing education to patient access - Responsible for communicating to service line partners of situations where rescheduling is necessary, due to lack of authorization or limited benefits and is approved by clinical personnel; - Ensures that proper authorization is in place for inpatient, elective, outpatient, surgical, urgent/emergent services and held responsible for timely notification to payers of the patient’s visit to the facility to protect financial standing of the organization. Escalates non-authorized accounts/visits to management; - Ensures all benefits (Copays, Deductibles, Co-Insurance, OOP, LTM), authorizations, pre-certifications, and financial obligations of patients, are documented on account, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts and denial prevention.; - Maintains a close working relationship with clinical partners, and ancillary departments to ensure continual open communication between clinical, ancillary, and Patient Access & Patient Financial Services, Surgical Scheduling departments. Case Management, and Utilization Review to facilitate the sending of clinical information in support of the authorization to the payer, as assigned; - Monitors team mailbox, e-mail inbox, faxes, and phone calls responding to all related PAVE account issues, within defined time frames; Adheres to the department accuracy and performance standards. - Contact payer to obtain prior authorization. Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization; 10. Provide standardized documentation within system to identify prior authorization and the criteria surrounding such authorization; Verify that all insurance requirements have been met; Notify patient, Provider’s Office, Scheduling and Financial Counselor immediately when insurance coverage is inadequate or has been terminated. 11. Advises providers and their clinical staff when issues arise relating to obtaining prior authorization; educate providers and their clinical staff regarding the prior authorization process. 12. Stay informed and research information regarding insurance criteria for prior authorization; Attend department staff meetings, professional education sessions, complete e-learnings and mandatory training. 13. Performs other duties as assigned by PAVE Leadership. Educational/Experience Requirements: - 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. - Preferred experience with the Epic Hospital Billing System - Associates Degree Accounting, Finance, Business Administration or Healthcare related field preferred - Minimum two (2+) years of Revenue Cycle Experience in lieu of degree Required License/Certifications: - 1 or more Certifications preferred: - 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 Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens. Physical Demands - The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary. Pay Range $17.50—$26 USD Luminis Health Benefits Overview: • 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 and more *Benefit offerings based on employment status Opt-in for text notifications! Luminis Health's two-way SMS texting platform lets you receive notifications and messages from our Talent Acquisition team directly on your phone. To enable this feature, select "yes" when asked to "opt-in to receive text messages" and to "Receive updates from a recruiter about this job via SMS" when completing your application. Once you are opted in, you can easily opt-out at any time. Standard text messaging rates may apply based on the candidate's mobile carrier plan. Luminis Health is not responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage charges.

United States
$18 - $26 / hour
Job Closed