Coordinator, Pre-Authorization Verification & Eligibility (PAVE)

The PAVE Coordinator initiates pre-authorization requests with payers for claims requiring approval, ensuring procedures are pre-certified and medically necessary. This role involves communicating with payers, patients, physician offices, and hospital clinical staff to verify insurance eligibility and benefits. The position also monitors authorization appropriateness, conducts quality assurance, and documents patient financial obligations to prevent denials.