Radiology Scheduler/ Pre-Auth Specialist

DESCRIPTION OF POSITION:

• Schedules patients for imaging procedures and advises patients of surgical and financial pre-procedure requirements. Coordinates and schedules appointments for imaging procedures at the clinic, ambulatory surgery center or hospital.

RESPONSIBILITIES AND DUTIES:

• Coordinate and schedule radiology procedures and appointments as designated by physicians / clinics according to established policies and procedures.
• Assure timely completion and maintenance of radiology prior-authorizations for designated MMG clinics.
• Emphasize prioritization of STAT radiology appointment requests and precertification needs.
• Interact with patients’, physicians and other staff within the clinics and at outside facilities/insurance companies in providing accurate, timely and responsive information.
• Coordinate processes and timing as required to meet physician and facility requirements.
• Schedule radiology imaging appointments and survey opportunities for expanding access within the department in filling last minute cancellations / openings with a high level of responsiveness.
• Obtain authorization for imaging from patient’s insurance company. Demonstrate time management and multi-tasking by cataloguing like-tasks in the same sequence (i.e. BCBS online prior-authorizations, capturing more than one prior-authorization within the same interaction with insurance, prioritizing urgent patient needs, gathering needed information in advance, etc.)
• Provide patient with information and advise patients of imaging procedure and financial requirements.
• Submit patient clinical and financial information to facility assuring appropriate medical records release, if needed.
• Answer and screen telephone calls in a courteous manner, and record messages for physician and other personnel.
• Obtain accurate information from patients and ensure all registration forms are complete.
• Collect patient pre-payments as directed daily.
• Provide information to patients regarding unpaid balances prior to procedure.
• File records in appropriate sections of patient electronic or paper charts and keep patient charts in proper order.
• Review financial and clinical paperwork to assure completion before the scheduled imaging procedure date.
• Maintain files and patient records in a confidential manner.
• Knowledge of clinic policies and procedures, medical terminology and insurance practices.
• Perform other related duties as directed or assigned.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• High school diploma or GED.
• Minimum of two years of administrative assistant experience in a medical office, including experience with insurance preauthorization and patient collections.
• Knowledge of grammar, spelling, and punctuation to type, review and edit reports, documentation and correspondence.
• Knowledge of basic arithmetic to make calculations, balance and reconcile figures, and make changes accurately.
• Skill in operating office equipment Skill in handling paperwork/filing adequately, handling incoming phone calls and triaging appropriately, written and verbal communication, gathering, interpreting, and reporting insurance information, trouble-shooting insurance issues and resolving appropriately.
• Ability to type 45 words per minute using word-processing software. Able to learn/use other computer programs including Microsoft® Excel, e-mail, Internet, and Microsoft® PowerPoint.
• Ability to work effectively as a team member with physicians and other staff, to sort and file materials correctly by alphabetic or numeric systems, to interpret and understand insurance benefits and reimbursement, to flexibly respond to changing demands, to organize and prioritize tasks effectively, to communicate clearly, to work with little supervision, to establish and maintain effective working relationships with patients, employees, and the public.

Physical Demands/Work Environment

• Work requires light duty lifting and ability to remain in a stationary position 50% of the time.
• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.
• Must be able to exchange accurate information with patients, family, peers and medical personnel.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.