Job Description
Medical Pre-authorization Team is looking for a dedicated DRG Inpatient Pre-authorization Specialist to join us in strengthening our approvals and drive case management.
Job Purpose
- The jobholder will be responsible for managing inpatient cases as per defined TAT and ensuring accuracy of DRG codes submitted by Healthcare Providers.
- Jobholder must possess ability to deliver in a metric driven high pressure environment which functions in real time.
- Strong attention to detail; high degree of speed and adjudication accuracy.
- Strong proficiency in handling computer and software skills.
Job Responsibilities
- Visit providers to manage inpatient cases, review DRG codes/severity levels submitted by healthcare facilities.
- Coordinate with physicians/providers efficiently and Ensure effective communication with provider.
- Negotiate cost with providers, ensure correct length of stay of inpa...