Authorization & Account Verification Specialist

Job Description

Job Description

Join our Culture of Caring!

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.

Advanced Radiology is one of the largest independent radiology practices in the tri-state area with the most experienced radiologists. We look for team members who want to grow and be professionally challenged, while enjoying a rewarding, caring, and friendly environment. We are looking for a Authorization & Account Verification Specialist to join our team. The pay range for this role will depend on experience and qualifications.

Schedule : Monday- Friday 8 : 30am to 5pm

P osition 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 Job 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 :

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.

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.

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.

Knowledge, Skills and Abilities :

Educational Requirements :

Competencies :

To perform the job successfully, an individual should demonstrate the following competencies :

Physical demands / Working Conditions :

Work is performed in a business office environment. Work is primarily stationary, requires sitting or standing for long periods of times; Manual dexterity and eye-hand coordination sufficient to operate a keyboard and other office equipment is required.

Qualifications :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The above declarations are not intended to be an all-inclusive list of the duties and responsibilities of the job described, nor are they intended to be such a listing of the skills and abilities required to do the job. Rather, they are intended only to describe the general nature of the job.

Work Smart, Live Well : The success of Advanced Radiology is earned every day through our dedication to quality patient care and continual improvement of the patient experience. Our success allows us to enjoy a wide range of benefits designed to support and enhance our lives, both at work and at home.

Health Benefits :

Additional Benefits :

Advanced Radiology is an Equal Opportunity Employer, offering outstanding compensation and benefits plans designed to reward and retain exceptional employees. Apply today and join our team of dedicated and caring professionals!