[Hiring] Authorization / Eligibility Representative @Radiology Partners

Role Description

Obtains documents, verifies, and conducts follow-up on insurance authorizations and insurance eligibility as required for scheduled exams. Consults with supervisor on complex and/or difficult situations.

• Enters data accurately into system, applying CPT codes to match authorization for exam.
• Consults with Modality Protocol, Clinical Managers, or technologist, as needed to ensure accuracy and smooth workflow.
• Contacts insurance companies to obtain prior authorization and predetermination for exams ordered by practice providers.
• Checks insurance eligibility to ensure that the information provided matches the insurance carrier’s database information.
• Prepares written communication to notify appropriate staff of authorization updates and/or changes for insurance carriers.
• Interacts with external customers to inform and educate regarding authorization procedures in support of marketing efforts to enhance relationships with referring physician offices.
• Works collegially and professionally with all internal and external staff members and physicians.

Qualifications

• High school diploma or equivalent.
• Post-secondary education preferred.
• Experience with Radiology Information System (RIS) preferred.
• Must possess excellent diction and communication skills.
• Excellent telephone manner, customer service, and interpersonal skills.
• Strong attention to detail, organizational, and problem-solving skills.

Requirements

• Must be able to work in a collaborative and supportive environment.

Benefits

• Health and wellness coverage options.
• 401(k) with employer offerings.
• Paid time off and paid holidays.
• Incentive and productivity programs (where eligible).
• Family planning and telehealth benefits.