Job Position - Verification Authorization Rep
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Verification Authorization Rep
- Uses real time work list to prioritize workload in obtaining patient authorization prior to the scheduled exam date and time.
- Responsible for verification of patient insurance eligibility.
- Determine individual insurance plan radiology benefits for scheduled exams.
- Obtain clinical history from referring physician in order to obtain authorization on a scheduled exam.
- Adheres to Documentation Guidelines pertaining to status of patient benefits and/or authorization.
- All eligibility, authorization, and determination of benefits information obtained are to be documented appropriately in the patient's medical record in Fuji RIS.
- Upon completion of the eligibility and authorization process, complete the Authorization Task/tasks.
- Communicate with patients and/or referring physicians on non-covered benefits or exam coverage issues.
- Adheres to all HIPAA Guidelines.
- Provide assistance to Imaging Center Staff, Scheduling Staff, and Assessment Coordinator Departments regarding Authorization and Eligibility.
- Stay informed; communicate any updates and/or changes in Payor authorization requirements.
- Inform Contact Center Coordinators and Department Management of potential problem cases to receive direction on how to resolve situations.
- Responsible for addressing prior exams on worklist.
- Participate in Team and Payor meetings.
- Attends scheduled up-training courses as needed on new and revised SMIL Authorization processes and changes in workflow.
- Answers incoming calls in Authorization queue.
- Performs other related duties as assigned or requested.
- Demonstrates a commitment to "World Class Customer Service" and promotes a positive work environment
- High School diploma or equivalent
- 2-3 Years experience in Insurance Eligibility and Authorization Process preferred
- Radiology/Medical Industry related Certification is a plus, but not required