Precertification Coordinator/Insurance Verification Rep

We are seeking an Insurance Verification/ Precertification Coordinator to join our team! Who are New Rochelle Radiology and Rezolut? New Rochelle Radiology ("NRR") is part of Rezolut, a national medical imaging provider with over 30 centers across the US. NRR has served the medical imaging needs of patients and physicians in Westchester County and the surrounding areas for over 50 years. Our mission is to provide high-quality imaging and accurate and timely results in a friendly and stress-free environment. We're looking for strong teammates, with leadership potential, to join NRR. In just four years, we've helped build Rezolut into an organization with 4 imaging business lines, a presence in 9 states and over 600 employees providing 650,000 scans annually. If joining a team and company like this sounds interesting to you, let's connect! You can learn more about Rezolut on our home page - Summary/Objective The Preauthorization Specialist/Insurancer Verification Representative will perform clerical functions for patient billing, including verification of insurance information, procurement of Prior Authorizations and resolution of problems to ensure a clean billing process. Essential Functions Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Maintain patient demographic information and data collection systems Verify insurance eligibility for medical insurances, Workers Compensation and No Fault, for upcoming appointments, by utilizing online websites or contacting carriers directly. Work with referring provider offices, medical insurances, Workers Compensation and No Fault insurance to obtain prior authorizations for upcoming imaging appointments. Review patient deductibles and/or copays and enter in the billing system and spreadsheets provided to the front-end department. Coordinate with front-end regarding scheduling errors. Assist front-end staff and call center staff with carrier websites and verification of eligibility. Work in conjunction with staff to ensure clean billing. Work in conjunction with the Billing Company to resolve coding issues. Enter insurance referrals as needed. Participate in development of organizational procedures and update forms and manuals. Answer questions from patients, clerical staff, and insurance companies. Participate in educational activities and attends staff meetings. Assist in the development and communication of SOP for key areas to improve accuracy and understanding of processes. Follow-up on accounts that required further evaluation. Maintain strict confidentiality; adhere to HIPPA guidelines/regulations. Competencies/Skills Excellent written and verbal communication skills. Strong organizational skills. Ability to be proactive and take initiative. Customer/Client Focused. Strong attention to detail. Knowledge of CPT and ICD10 codes. Ability to work in a fast paced environment with high call volume. Knowledge of Insurance Websites. Ability to work independently and as part of a team. Excellent computer skills Commitment to quality patient care and exceptional customer service Excellent communicator who can form and maintain effective working relationships with staff, radiologists, referring physicians and patients Requirements High School degree or equivalent Minimum of 1 year of insurance verification, prior authorization and billing experience required Ability to work in a fast paced, patient focused environment Bi-lingual (English, Spanish) a plus What We Offer Immediately accrue PTO as you work! (Full Time) 6 Observed Holidays Medical, Dental, Vision, Life and other voluntary insurances for full-time employees 401(k) Retirement plan Employee Assistance Program Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This position requires standing, walking, and sitting. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. #NorthEastHP

Created: 2024-10-29