DUTIES:

• Perform pre-authorizations when required by various insurance carriers for various Radiology services and document appropriately.
• Communicate with insurance companies regarding patients’ treatment and services provided
• Communicate with the staff, departments, and/or patients regarding the status of the pre-authorizations and help minimize patient wait times as much as possible
• Prioritize incoming prior authorization requests according to urgency
• Request, track, and obtain prior authorization from insurance companies within the time allotted for services using various mechanisms/tools such as insurance websites/portals, fax, or verbal communication
• Follow up on prior authorizations submitted and initiate appeals for denied requests
• Use ICD-10 and CPT codes accurately and adequately in the submission of prior authorizations
• Demonstrate and apply knowledge of medical terminology, high proficiency of general Radiology exams, including HIPAA regulations
• Document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format
• Ability to evaluate options and make efficient decisions
• Organizational skills sufficient to maintain consistently accurate records
• Understands insurance requirements for prior authorizations and serves as a primary resource to clinic staff regarding prior authorization requirements for all services provided
• Works daily queues according to department directives to ensure all payer-specific authorization requirements are met, and authorizations successfully obtained while consistently meeting department productivity standards
• Proactively coordinate all information required of the authorization process, ensuring complete, accurate, and timely information collection and entry
• Effectively organize and manage workload to ensure timely completion
• Other Duties as assigned

EDUCATION EXPERIENCE REQUIREMENTS:
High school Diploma required. College Degree preferred.

Full Medical Benefits, dental and vision