Authorization & Eligibility Representative | Radiology Partners | Remote (United States)
Job Description
General information
Job Title Authorization & Eligibility Representative Functional Area Front Office – Patient Services City Remote Work Location Type Remote Employment Type Full-time (30+ hrs/week)/FULLTIME
Description & Requirements
Position Description & Requirements
practice OVERVIEW
, through its owned and affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare.Radiology is a team sport, and is building a community of physicians and support teammates who embody our practice values and believe in our bold mission to transform radiology.Our support team is a vital force within the practice, using their gifts and talents to improve the overall healthcare experience.Using a proven healthcare services model, provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.
Position Summary
is seeking an Authorization and Eligibility Representative who will work to ensure insurance verification and authorization is obtained for medical services.This position requires in-depth knowledge of billing, collections, insurance verification and pre-cert experience.
Position Duties and Responsibilities
- Incoming and outgoing phone calls from patients, doctor offices, and insurance companies maintaining a high level of customer and client service
- Follow the work que/schedule daily to ensure that all required exams have the appropriate authorization for payment of the scheduled exam(s)
- Work que must be worked 3+ days prior to any scheduled appointments (for insurance eligibility and benefits) accounting for weekends and holidays to allow adequate time to receive authorization before the day of service
- Accurate and timely documentation of all work research, communications, copay, deductible, and / or co-insurance on each individual patient accounts and other applicable programs
- Follow all practice policies regarding HIPAA, PHI, and compliance including protecting patient privacy in office
- Responsible for driving process improvement initiatives related to front end revenue cycle functions, in collaboration with the operations leadership and divisional managers
- Responsible for improvements in operations of patient business services, insurance verification, and authorizations
- Work with managers of staff accountable for charge capture, coding, charge entry, insurance follow up, reimbursement analysis, or other financial functions
- Work claim denials and appeals
- Other duties as assigned by manager
DESIRED PROFESSIONAL SKILLS AND EXPERIENCE
- High School Graduate or GED equivalent preferred
- 2+ years in healthcare billing, AR, eligibility, and pre-certs preferred
- Medical CPT and ICD10 code knowledge a plus
- Knowledge of customer service concepts and company policies including safety, privacy and HIPAA regulations
- Background with eClinicalWorks Practice Management System Preferred
- Excellent problem-solving skills
- Ability to work independently in a fast-paced, high productivity environment
- Excellent communication skills to communicate with patients, physicians, clients, coworkers, and management staff
- Ability to document accurately and concisely
- Ability to meet deadlines and prioritize diverse projects
- Strong organizational skills
is an equal opportunity employer.RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system overall. We hold that diversity is a key source of strength from which we will build a practice culture that is inclusive for all. Our goal is to empower and engage the voice of every teammate to promote awareness, compassion and a healthy respect for differences.
The salary range for this position is $17.00 – $22.00 Final determinations may vary based on several factors including but not limited to education, work experience, certifications, etc. This role is also eligible for an annual discretionary bonus. In addition to this range, offers competitive total rewards packages, which include health & wellness coverage options, 401k benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements).
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