Authorization & Account Verification Specialist

Join our Culture of Caring! 

 Advanced Radiology is one of the largest independent radiology practices in the tri-state area with the most experienced radiologists. We look for team members who want to grow and be professionally challenged, while enjoying a rewarding, caring and friendly environment. 

Position Summary:

The Authorization & Account Verification Specialist reviews radiology orders to verify demographic information, insurance eligibility, review prior-authorization requirements, initiate or verify authorization for requested examination CPT code (when applicable) by insurance, third party liability or other and follow medical policies when applicable.  Entering complete and accurate information in the patients account.

 Essential Job Duties and Responsibilities:

• Review requested radiology order for patient demographic data, insurance/billing information, requested CPT and clinical information
• Ensure all patient demographic and insurance information is current and accurate utilizing EPIC EMR
• Verify prior authorization requirements for requested examination CPT code by covering carrier
• Accurate and timely communication with needed staff on authorization issues
• Responds to telephone, electronic and in person inquires and complaints.
• Thorough review of scheduled CT, MR, NM, PET, Doppler US patients to ensure accurate and timely receipt of demographic, insurance and clinical information required for the patient’s examination.  
• Maintains positive relations and interactions with insurance companies, referring offices, patients and internal ARC staff.
• Demonstrates initiative in problem solving and resolving customer satisfaction issues.
• Audits their own work to ensure quality and reports safety or quality events
• Attends meetings, training, learning and development sessions as required
• Respects patient confidentiality by adhering to HIPAA standards.

 Knowledge, Skills and Abilities:

• Ability to multi-task and function in a fast paced environment.
• Customer service skills - empathetic, active listener, who has strong follow through skills.
• Proficient computer and data entry skills.
• Basic knowledge of anatomy and medical terminology preferred.
• Listen to feedback or constructive criticism from management and apply it to themselves.
• Critical thinking – the ability to think creatively, problem solve and work independently.
• Knowledge of ICD-10, CPT codes. 
• Must be comfortable utilizing de-escalation skills when communicating with patients and physician offices in crisis.

 Educational Requirements:

• High school diploma or general education degree (GED)
• Knowledge and understanding of health insurance carrier eligibility and authorization processes
• 1-2 years related experience in healthcare office setting, preferably in Radiology
• EPIC experience a plus

Advanced Radiology offers outstanding compensation and benefits plans designed to reward and retain exceptional employees. Our comprehensive benefits package includes:

Medical, Dental and Vision Insurance; Prescription Plan; HSA with matching employer contribution, Company Paid Life Insurance, 401K Plan and Profit Sharing with employer contribution, Paid Holidays, and generous Paid Time Off. You will also receive free company swag, fun wellness challenges with prizes, awards and recognition programs, and much more!

 Advanced Radiology Consultants is an Equal Opportunity Employer.   Apply today and join our team of dedicated and caring professionals!