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Position Details

Schedule/Shift:
Swing
Employment Type:
PRN
Location City:
Remote
Work Location Type:
Remote

 

PRACTICE OVERVIEW 

MBB Radiology, a Radiology Partners Practice, is a multi-state, comprehensive outpatient imaging network offering access to hundreds of board-certified, sub-specialized radiologists. We provide leading comprehensive, convenient, state-of-the-art diagnostic imaging care. Our goal is to provide high-quality, low-cost diagnostic imaging studies close to where our patients live and work. From our sub-specialized radiologists to our registered technologists and professional clinic staff, our commitment to accuracy and the patient's experience is not just an expectation, it is our mission. Together with Radiology Partners, our mission is To Transform Radiology.  

 

POSITION SUMMARY 

The Pre-Certification Specialist's core duties are contacting insurance companies and third-party administrators to determine pre-authorization and/or medical necessity requirements for basic and high-tech outpatient radiology exams and procedures. The specialist is responsible for obtaining the pre-authorization before the scheduled services are performed. The representative will act as a liaison between the patients and referring physician offices when needed to obtain additional clinical documentation. 

 

POSITION DUTIES AND RESPONSIBILITIES 

  • Initiate the authorization request to the appropriate insurance company.  

  • Oversight and Participation in all aspects of radiology prior authorization process. 

  • Responsible for obtaining and communicating pre-authorization as needed per insurance company requirements. 

  • Responsible for all follow-up phone calls to the insurance company or doctor's office for authorization status or to request additional information.  

  • Gather all necessary clinical information from the referring doctors' offices to complete the prior authorization process. 

  • Communicating with other staff about patient pre-authorization status 

  • You are communicating with patients and providers about pre-authorization status before their service date.  

  • Verify receipt of all necessary pre-authorization documents prior to the procedure 

  • Handling incoming and outgoing calls  

  • Process online authorization as needed through payor portals. 

  • Other duties as assigned. 

 

 

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE 

  • High School or equivalent preferred 

  • Background in healthcare is preferred 

  • Background with eClinicalWorks Practice Management System preferred 

  • Ability to work independently 

  • Ability to work in a fast-paced, high productivity environment 

  • Ability to exercise judgement and make decisions 

  • Excellent communication skills to communicate with patients, physicians, clients, coworkers, and management staff 

  • Ability to document accurately and concisely 

  • Excellent phone and computer skills 

  • Ability to maintain sensitive information in confidence 

  • Ability to meet deadlines and prioritize diverse tasks 

  • HIPAA and OSHA knowledge 

  • Strong organizational skills 

  • Working knowledge of medical billing and managed care 

 

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.  

 

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.