About the position
Responsible for verifying benefits and/or obtaining pre-certification/pre-authorization for all exams scheduled at the facility. Assists with coordinating care for all patients with prescheduled diagnostic appointments within the imaging center including pre-screening and preparation instructions prior to and after patient arrival. Handles correspondence regarding patient insurance, authorization, demographics, appointments, and financial information as applicable. Handles all correspondence, maintains files, acts as a patient liaison, receptionist, screens telephone calls within department and compiles departmental monthly reports.
Responsibilities
• Working knowledge of authorization criteria specific to both insurance payor and exam type.
• Working knowledge of retro authorization and appeals process and attempting to obtain when needed.
• Maintain an understanding of authorization standardization workflow.
• Ensures that patients have a physician order before tests are performed or at the time of scheduling.
• Understanding of the patient registration process including patient demographic, insurance benefits, and financial responsibility information.
• Collect patient co-payments, deductibles, bad debt, and outstanding balances when applicable.
• Manages multiple phone lines efficiently and with excellent customer service skills and telephone etiquette.
• Verifies all medical benefits for scheduled exams and communicates medical insurance coverage to the patient and/or legal guardian.
• Provide good faith estimates to self-pay patients timely to remain in compliance with the No Surprise Act.
• Inform all true self-pay patients of presumptive eligibility opportunities and financial counseling options available.
• Collaborate with the physician's office staff as appropriate to obtain the necessary documentation, including pre-authorizations for all diagnostic exams.
• Pre-register all patients in an accurate and efficient manner.
• Demonstrates understanding of medical diagnosis with correct spelling.
• Demonstrates complete understanding and ability to apply patient access policies and procedures.
• Demonstrates knowledge to scan appropriate documents and search for documents in EPIC.
• Demonstrates knowledge of insurance and authorization web portals.
• Demonstrates ability to analyze and evaluate any presented problems by utilizing critical thinking.
• Knowledge of electronic prior authorization process specific to Rhyme.
• Consistently coordinates work to achieve maximum productivity and efficiency during the assigned shift.
• Demonstrates a willingness to stay late, and work weekends or other shifts to accommodate department needs.
Requirements
• High school graduate or equivalent.
• Knowledge of insurance verification, with two years experience verifying and obtaining medical pre-certification.
• Solid written and verbal communication skills.
• Strong computer experience, including MS Word and Excel, and experience using other office equipment. Will be required to learn department-specific programs.
• Demonstrated ability to prioritize and handle multiple tasks simultaneously.
• Ability to work with minimal supervision and effectively solve problems.
• Working knowledge of medical terminology.