PRIMARY FUNCTION: Provide remote assistance to medical offices in the United States by verifying insurance eligibility for patient appointments, managing and routing documents, obtain authorization from insurance companies and providing excellent customer service. The coordinator will also ensure accurate communication with patients, parents, and internal teams to resolve issues and complete tasks efficiently.

ESSENTIAL FUNCTIONS OF THE JOB: (This list may not include all of the duties that may be assigned.)

• Verify insurance eligibility for future patient appointments using all available resources (e.g., system, web portals, phone).
• Follow Pediatric Associates Eligibility Verification Quality Checklist to determine insurance eligibility and identify specific health plan requirements.
• Review patient insurance details and update accurately in the system.
• Review and understand documentation required by insurance companies to obtain authorization, including clinical notes, lab results, consult notes
• Communicate eligibility issues to patients/parents and document actions taken.
• Complete all assigned appointments and tasks within the expected timeframe and productivity standards.
• Maintain "logged in" status to fax server during working hours, ensuring documents are routed to the correct recipient.
• Analyze documents received via fax and follow Pediatric Associates Document Manager routing procedures.
• Communicate effectively with the office via email, Microsoft Teams, and phone to coordinate appointment reschedules and gather signatures for documents.
• Identify time-sensitive documents and respond with urgency.
• Ensure clear and concise communication with supervisors and escalate issues as needed.
• Meet quality and productivity standards as determined by the organization.

PERFORMANCE REQUIREMENTS:

• Education: High School Diploma or equivalent.
• Language: Must be proficient in both English and Spanish.
• Location: Monterrey, N.L., Mexico (Monterrey metropolitan area).
• Experience: Minimum of 1 year of relevant experience preferred (document routing processes, document translation, customer service or call center)
• Skills: Must be detail-oriented, with strong organizational skills. Ability to handle high volumes of tasks (including patient eligibility verification and document analysis). Must be proficient in using office equipment and software (e.g., Microsoft Teams, Microsoft Office and email).

Working Conditions: Professional office environment with clear and concise communication required. Ability to operate office equipment (keyboard, copier, etc.).