Advanced Radiology Consultants · 4 months ago
Authorization & Account Verification Specialist
Shelton, CT
Full-time
Onsite
Entry Level
1+ years expAdvanced Radiology Consultants is one of the largest independent radiology practices in the tri-state area, committed to exceptional patient care. They are seeking an Authorization & Account Verification Specialist to review radiology orders, verify demographic and insurance information, and ensure prior authorization requirements are met.
Health CareHealth DiagnosticsMedical
Responsibilities
Review requested radiology order for patient demographic data, insurance/billing information, requested CPT and clinical information
Ensure all patient demographic and insurance information is current and accurate:
Utilizing EPIC EMR, referring office and/or patient to verify and update patient demographic data and insurance coverage, real-time eligibility, commercial insurance or third party websites, telephone verification or both to verify patient’s coverage and benefits
Verify prior authorization requirements for requested CPT by covering carrier
Obtain pre-authorizations on high modality imaging requests
Conduct a thorough review of all documentation submitted to support diagnostic imaging procedure; including script review from referring physician, detailed review of EMR and/or clinical information submitted by referring physician and review of patient insurance information
Enters detailed notes regarding communication with insurance carriers and/or health care providers and steps taken in authorization process
Verify referring office provided prior-authorization by patient, date of birth, referring provider, CPT and rendering company and/or location
Accurate and timely communication with needed staff on authorization issues
Communicates regularly with insurance companies, health care providers, internal scheduling department, front desk coordinators and clinical staff at sites; on any exams that require clinical review and/or denials from insurance carriers
Responds to telephone, electronic and in person inquires and complaints
Thorough review of scheduled CT, MR, NM, PET, Doppler US patients to ensure accurate and timely receipt of demographic, insurance and clinical information required for the patient’s examination
Maintains positive relations and interactions with insurance companies, referring offices, patients and internal ARC staff
Demonstrates initiative in problem solving and resolving customer satisfaction issues
Audits their own work to ensure quality and reports safety or quality events
Attends meetings, training, learning and development sessions as required
Respects patient confidentiality by adhering to HIPAA standards
Qualification
Required
High school diploma or general education degree (GED)
Knowledge and understanding of health insurance carrier eligibility and authorization processes
1-2 years related experience in healthcare office setting, preferably in Radiology
Ability to multi-task and function in a fast paced environment
Customer service skills - empathetic, active listener, who has strong follow through skills
Proficient computer and data entry skills
Listen to feedback or constructive criticism from management and apply it to themselves
Critical thinking - the ability to think creatively, problem solve and work independently
Knowledge of ICD-10, CPT codes
Must be comfortable utilizing de-escalation skills when communicating with patients and physician offices in crisis
Preferred
Basic knowledge of anatomy and medical terminology preferred
EPIC experience a plus
Benefits
Medical and Prescription Drug Coverage
Dental Coverage
Vision Coverage
Health Savings Account (HSA) with Matching Employer Contribution
Generous Paid Time Off (PTO)
Paid Holidays
401(k) Plan with Employer Contribution
Annual Profit-Sharing Plan Contribution
Paid Opt-Out Benefit Option
Basic Life and Accident Insurance
Company
Advanced Radiology Consultants
Advanced Radiology Consultants is a diagnostic imaging center that provides imaging services and image guided procedures.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Clark Yoder
Chief Executive Officer
Ian Karol
Chief Medical Officer
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