- Job Detail
PRACTICE OVERVIEW
Radiology Partners, 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 Radiology Partners 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, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.
POSITION SUMMARY
Radiology Partners is seeking a front-end, Eligibility Revenue Cycle team member. This team is responsible for all aspects of Radiology Partners patient eligibility accuracy, and correction of eligibility denials. This includes corrections of eligibility and verification failures, root cause discovery and error trending. The Representative will serve as a subject matter expert and face of RCM as it relates to eligibility.
POSITION DUTIES AND RESPONSIBILITIES
Verify and correct patients’ insurance and policy information in an accurate and timely manner, to ensure cleanliness of claims prior to payer submission
Identify system failures as it relates to payer mapping and build errors
Identify eligibility-related issues and trends. Communicates appropriately to the Supervisor regarding these and/or other departmental issues
Work collaboratively with off-shore team members to improve overall eligibility performance and reduce denials
DESIRED PROFESSIONAL SKILLS AND EXPERIENCE
Knowledge of medical billing and eligibility practices, medical terminology, and claim processing requirements
Insurance Payer/Plan knowledge – insurance payer requirements, co-ordination of benefits, claims formatting, etc. (BUCHA Payers, Workers Comp, Auto)
Ability to pay close attention to detail for extended periods of time
Ability to apply good judgment and problem-solving skills.
Ability to communicate clearly through email and on the telephone
Ability to organize and prioritize tasks effectively
Ability to read, understand and follow oral and written instructions
Familiar with payer claim processing and denials
Familiar with clearinghouse claim filing and processing – including knowledge about payer ids, 277/278 EDI files, and payer claim rejections
Experience with insurance payers’ eligibility requirements and common issues
Experience with insurance payer portals, eligibility verification, and eligibility response information
Self-driven
Ability to work independently
Ability to work in a fast-paced, high productivity environment
Ability to exercise judgement and make decisions
Radiology Partners 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 hourly range for this position is $17.00 - $20.00. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location etc. In addition to this range, Radiology Partners offers competitive total rewards packages, which include possible incentive and productivity programs, 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).
CCPA Notice: When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History.
Radiology Partners participates in E-verify.