Radiology Scheduler II

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