4 Availity Jobs

We are seeking an organized and detail-oriented individual to join our team as a US Operations Coordinator in the Intake Team. As the initial point of contact for patients, you will play a vital role in ensuring smooth and accurate intake processes. Your primary duties will include verifying insurance, checking eligibility, and obtaining authorizations for medical services. Your responsibilities will involve collecting and accurately recording patient information, processing incoming referrals and inquiries for medical services, verifying patient insurance coverage and benefits, determining patient eligibility for medical services based on insurance coverage, and providing clear information to patients regarding insurance coverage and financial responsibilities. Additionally, you will collaborate with other teams as necessary and maintain accurate records of patient intake activities while ensuring compliance with HIPAA regulations. The ideal candidate should possess a Diploma/Bachelor's degree in any field, be fluent in English with strong communication skills, have previous experience in the medical billing process, and ideally have an understanding of different types of insurances like Medicare, Medicaid, and Aetna. While experience in using portals like Careport and Availity is not mandatory, it is beneficial. A background of 1-3 years in US medical processes, familiarity with medical terminology, billing and coding procedures, insurance guidelines, and reimbursement practices is preferred, along with an understanding of healthcare insurance processes. Strong communication and interpersonal skills, a commitment to confidentiality, and the ability to multitask and prioritize workload effectively are essential. This is a full-time position based in our office at IT Park, Chandigarh, with shift timings requiring work during the night shift (US shift). We offer ample opportunities for professional growth and development, along with a competitive salary package. Proelio Technologies provides comprehensive support functions to PathWell Health in the United States. Our dedicated teams, including HR, Intake, QA, RCM, IT Support, and FP&A, actively work to assist PathWell Health in their operations across Connecticut, Virginia, West Virginia, and California. If you are looking to join a dynamic team and contribute to the healthcare industry, we welcome your application for the US Operations Coordinator position.,

AR Caller (Accounts Receivable Caller) Responsibilities: Contact insurance companies to follow up on unpaid/underpaid medical claims . Identify the reason for denials and initiate appropriate steps for resolution. Document call outcomes and maintain accurate records in the billing system. Work on reprocessing or appealing claims as needed. Achieve daily call targets and maintain call quality standards. Requirements: Good spoken English and communication skills. Familiarity with US insurance terminology (Medicare, Medicaid, Commercial, etc.) Prior experience in AR Calling or denial management preferred but not mandatory. Prior Authorization Executive Responsibilities: Initiate and follow up on prior authorization requests with insurance carriers. Coordinate with physicians or clinical staff to gather necessary documentation. Submit and track prior auths through payer portals or phone calls. Maintain authorization logs and ensure approvals are received on time. Update systems with accurate approval/denial details. Requirements: Strong communication and coordination skills. Knowledge of CPT codes, medical necessity, and insurance policies preferred. Familiarity with tools like Availity, Navinet, and payer-specific portals is a plus. EVBV Executive (Eligibility & Benefits Verification) Responsibilities: Verify patient insurance coverage by calling payers or using web portals. Check eligibility for procedures, visits, or services including copay, deductible, and policy status. Document and communicate insurance benefits and coverage accurately. Escalate discrepancies or inactive coverage to the billing/client team. Ensure verifications are completed within turnaround time (TAT). Requirements: Excellent English comprehension and phone etiquette. Understanding of insurance verification process preferred. Ability to work on portals such as Availity, Navinet, or insurance websites.

Neolytix provides management solutions aimed at igniting long-term success for healthcare providers nationwide. We provide a platform to incubate a conducive collaboration based on creating revenue and cost transformation within healthcare organizations. Work with a company where your work can make a real impact! As a Training process trainer specializing in US Healthcare processes, you will be responsible for creating engaging and comprehensive training materials, SOPs, and conducting On Job Training for the ramp-up period of training graduates. And a key resource for the SOP management. Leveraging your expertise in instructional design principles and your ability to conduct insightful interviews, you will craft high-quality trainer-led training content that ensures our workforce remains up-to-date and proficient in all areas of healthcare operations. Responsibilities: - Conduct thorough interviews with subject matter experts and stakeholders to gather comprehensive insights on US Healthcare processes, including medical billing, credentialing, etc. - Design and implement effective process knowledge test assessments to measure the understanding and proficiency of employees in key healthcare processes, fostering continuous improvement and skill development. - Regularly update the SOPs and enhance existing SOPs to reflect the latest developments, trends, and changes within the process, and maintain work hygiene. - Conduct On-Job-Training during the ramp-up period of the new Hires post the graduation of the training. - Conduct process training on RCM modules. - Utilize applications used in operations and create SOPs based on them to design training accordingly. - Proven experience in creating engaging and effective trainer-led training materials in the healthcare sector, focusing on medical billing, credentialing, and clinical documentation management. - Familiarity with learning management systems and multimedia tools to develop interactive and visually appealing training content. - Knowledge of US Healthcare regulations, compliance standards, and industry-specific best practices. Essential Functions: - Work collaboratively with Revenue Cycle colleagues to ensure work products meet quality and quantity expectations. - Possess critical and analytical thinking skills to strategize solutions and work independently. - Strong computer skills required, especially in EPIC, Availity, Waystar, and Microsoft Office tools. - Excellent verbal and written communication skills with the ability to demonstrate diplomacy and conflict resolution techniques. - Engage in teamwork, maintain positive working relationships, and ensure OJT work production meets defined expectations. - Perform other duties as assigned. Requirements: - Skills: Proficiency in computer applications like Explorer, Excel, Word, Outlook, EPIC (or other EHR software). - Ability to multi-task, assess organization/customer needs, and translate them into learning objectives. - Good communication skills both verbal and written. - Education: College graduation in any stream. - Knowledge of insurance billing, medical terminology, rules, regulations, US Insurances, managed care contracts, and compliance. - Experience: 4+ years of healthcare accounts receivable experience with expertise in un-adjudicated claim management, appeals, and pre-collections. Demonstrated ability to develop and train staff on processes and procedures. Neolytix is an equal-opportunity employer, celebrating diversity and committed to creating an inclusive environment for all employees.,

You are invited to apply for the position of Patient Caller! We are looking for individuals who possess 2-4 years of experience along with exceptional communication skills. As a Patient Caller, your responsibilities will include making calls to gather patient demographics and insurance details. You will be required to confirm eligibility and benefits to ascertain insurance coverage before patient appointments. Furthermore, identifying and securing essential authorizations, handling email intake to ensure completion and upload of patient consent forms to the EHR, and requesting referrals or authorizations from PCPs or insurance companies via phone, website, or fax will be part of your daily tasks. Familiarity with billing software and insurance portals such as Availity, UHC, etc., to submit claims will also be crucial in this role. Additional Details: - Location: Mandaveli - Shift Timing: 6:30 pm - 3:30 am - Job Types: Full-time, Permanent As part of our team, you can enjoy benefits such as paid sick time, paid time off, fixed shift schedule from Monday to Friday, working on the night shift in the US time zone, and a yearly bonus. The work location is in-person, providing an opportunity for you to contribute effectively in a collaborative environment.,