Luminis Health

The PAVE Coordinator initiates Pre-Authorization requests to payers for necessary approvals, communicating with payers, patients, physician offices, and clinical staff to pre-certify physician-ordered procedures. This role also involves monitoring medical necessity, obtaining necessary authorizations, conducting quality assurance, and ensuring proper documentation to prevent claim denials.

The PAVE Coordinator initiates Pre-Authorization requests to payers for procedures ordered by physicians, monitoring appropriateness and medical necessity, and ensuring necessary information is provided for authorization. This role involves extensive communication with payers, patients, physician offices, and hospital clinical staff to confirm or obtain necessary pre-certifications and conduct quality assurance.