Advanced Radiology Consultants
Authorization & Accnt Verification Specialist
Advanced Radiology Consultants, Shelton, Connecticut, us, 06484
3 weeks ago Be among the first 25 applicants
Mission With every action we take,
Advanced Radiology Consultants
is committed to building and maintaining the trust of our referring physicians and providing our patients with exceptional care.
Schedule M-F Day Shift - 8:30am to 5pm
Position Summary An Authorization & Account Verification Specialist reviews radiology orders to verify demographic information, insurance eligibility, review prior‑authorization requirements, initiate or verify authorization for requested examination CPT code (when applicable) by insurance, third‑party liability or other and follow medical policies when applicable. Entering complete and accurate information in the patients account.
Essential Duties and 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 by 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 by conducting 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; enter 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; communicate 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.
Respond to telephone, electronic and in‑person inquiries 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.
Maintain positive relations and interactions with insurance companies, referring offices, patients and internal ARC staff.
Demonstrate initiative in problem solving and resolving customer satisfaction issues; audit own work to ensure quality and reports safety or quality events; attend meetings, training, learning and development sessions as required; respect patient confidentiality by adhering to HIPAA standards.
Knowledge, Skills and Abilities
Ability to multi‑task and function in a fast paced environment.
Customer service skills – empathetic, active listener, strong follow‑through skills.
Proficient computer and data entry skills.
Basic knowledge of anatomy and medical terminology preferred.
Listen to feedback or constructive criticism from management and apply it to themselves.
Critical thinking – ability to think creatively, problem solve and work independently.
Knowledge of ICD‑10, CPT codes.
Comfortable utilizing de‑escalation skills when communicating with patients and physician offices in crisis.
Educational Requirements
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.
Competencies To perform the job successfully, an individual should demonstrate the following competencies:
Customer Service – manages difficult or emotional customer situations; responds promptly to customer needs.
Interpersonal Skills – maintains confidentiality; listens to others without interrupting; keeps emotions under control.
Oral Communication – listens and gets clarification; responds well to questions.
Teamwork – contributes to building a positive team spirit.
Ethics – treats people with respect; works with integrity and ethically; upholds organizational values.
Organizational Support – follows policies and procedures.
Professionalism – approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of status or position; accepts responsibility for own actions.
Quality – demonstrates accuracy and thoroughness; monitors own work to ensure quality.
Safety and Security – observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly.
Adaptability – adapts to changes in the work environment; able to deal with frequent change, delays, or unexpected events.
Attendance/Punctuality – is consistently at work and on time.
Work Smart, Live Well and Benefits We offer comprehensive benefits to support your life at work and home.
Medical and Prescription Drug Coverage
Vision Coverage
Health Savings Account (HSA) with Matching Employer Contribution
Generous Paid Time Off (PTO)
Paid Holidays
401(k) Plan with Employer Contribution
Basic Life and Accident Insurance
Advanced Radiology is an Equal Opportunity Employer. Apply today and join our team of dedicated and caring professionals!
#J-18808-Ljbffr
Mission With every action we take,
Advanced Radiology Consultants
is committed to building and maintaining the trust of our referring physicians and providing our patients with exceptional care.
Schedule M-F Day Shift - 8:30am to 5pm
Position Summary An Authorization & Account Verification Specialist reviews radiology orders to verify demographic information, insurance eligibility, review prior‑authorization requirements, initiate or verify authorization for requested examination CPT code (when applicable) by insurance, third‑party liability or other and follow medical policies when applicable. Entering complete and accurate information in the patients account.
Essential Duties and 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 by 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 by conducting 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; enter 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; communicate 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.
Respond to telephone, electronic and in‑person inquiries 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.
Maintain positive relations and interactions with insurance companies, referring offices, patients and internal ARC staff.
Demonstrate initiative in problem solving and resolving customer satisfaction issues; audit own work to ensure quality and reports safety or quality events; attend meetings, training, learning and development sessions as required; respect patient confidentiality by adhering to HIPAA standards.
Knowledge, Skills and Abilities
Ability to multi‑task and function in a fast paced environment.
Customer service skills – empathetic, active listener, strong follow‑through skills.
Proficient computer and data entry skills.
Basic knowledge of anatomy and medical terminology preferred.
Listen to feedback or constructive criticism from management and apply it to themselves.
Critical thinking – ability to think creatively, problem solve and work independently.
Knowledge of ICD‑10, CPT codes.
Comfortable utilizing de‑escalation skills when communicating with patients and physician offices in crisis.
Educational Requirements
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.
Competencies To perform the job successfully, an individual should demonstrate the following competencies:
Customer Service – manages difficult or emotional customer situations; responds promptly to customer needs.
Interpersonal Skills – maintains confidentiality; listens to others without interrupting; keeps emotions under control.
Oral Communication – listens and gets clarification; responds well to questions.
Teamwork – contributes to building a positive team spirit.
Ethics – treats people with respect; works with integrity and ethically; upholds organizational values.
Organizational Support – follows policies and procedures.
Professionalism – approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of status or position; accepts responsibility for own actions.
Quality – demonstrates accuracy and thoroughness; monitors own work to ensure quality.
Safety and Security – observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly.
Adaptability – adapts to changes in the work environment; able to deal with frequent change, delays, or unexpected events.
Attendance/Punctuality – is consistently at work and on time.
Work Smart, Live Well and Benefits We offer comprehensive benefits to support your life at work and home.
Medical and Prescription Drug Coverage
Vision Coverage
Health Savings Account (HSA) with Matching Employer Contribution
Generous Paid Time Off (PTO)
Paid Holidays
401(k) Plan with Employer Contribution
Basic Life and Accident Insurance
Advanced Radiology is an Equal Opportunity Employer. Apply today and join our team of dedicated and caring professionals!
#J-18808-Ljbffr