Authorization Specialist-IR

Base Pay Range:

$18.97 - $28.46

Job Description

The Supplemental Authorization Specialist - IR will fill in for vacation and sick calls at the Holy Family Outpatient Based Interventional Center. Monday-Friday day shift. This position is eligible for a 12% supplemental differential.

Summary: Coordinates, authorizes, and schedules interventional procedures in a friendly, courteous and professional manner. Interacts with the providers, other departments within Inland Imaging Clinical Associates, patients and their family members and outside contacts.

General Description: The Authorization Specialist - IR must be able to: work effectively and efficiently in a fast-paced environment in meeting continual deadlines; handle multiple priorities with constant interruptions; be highly organized to meet deadlines. Organizational skills are essential. Interacts with the radiologists, other departments within Inland Imaging, patients and family members and outside contacts. Excellent written, verbal, and personal communication skills; be tactful and diplomatic; and be highly confidential is required. Makes decisions regarding daily work priorities and other decisions based on company policies and procedures.

Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Obtains insurance authorization and or verification if required from all insurance payers for interventional procedures and imaging
• Verifies patient has insurance coverage and referral in place if needed for office visits/procedures
• Interacts with billing department regarding billed procedures/codes/authorizations
• Coordinates peer-to-peer conversations between Radiologists and insurance medical directors
• Submits clinical documents, case studies and additional information used for appeals
• Guides callers from outside offices and facilities on coding, protocols for initiating interventional procedures
• Processes inner office mail and emails regarding special cases, stat cases and follow-ups
• Obtains authorization and schedules all vein procedures including initial pre op instructions and prep
• Submits orders/H&P/insurance info to outside facilities for scheduling of procedures
• Interacts with outside vendor to coordinate information for preauthorization of Y-90 procedures

Schedules patient consultations and follow-up exams including diagnostic tests as needed.

• Interacts with patients prior to and after exam, communicating authorization for interventional and vein procedures, treatments, outcomes, and possible complications regarding the authorization.
• Answers and fields patient phone calls regarding authorization and insurance.
• Checks and submits insurance preauthorization forms prior to procedures online
• Assures imaging and procedure orders are authorized and distributed in a timely manner
• Monitors and follows up on all authorizations and submissions with all insurance payers
• Interacts with Radiologists, nursing staff and other staff members to assure prompt quality patient care.
• Other projects and duties as assigned

General Duties and Responsibilities

• Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.
• Follows all Health and Safety policies and guidelines of Inland Imaging or its partners depending on work location.
• Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.
• Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.
• Honest, pleasant manner and good personal hygiene.
• Free of alcohol and drug abuse.
• Ability to access multiple worksites in a timely manner.
• Excellent communication and interpersonal skills.
• Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.
• Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.
• Ability to consider individual needs in communication with and assessment and treatment of patients of all ages.
• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
• Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
• Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.
• Quarterly quality assurance meeting attendance is required for this position.
• Attendance is a requirement for this position.
• Rotates to other shifts and locations as needed.

Supervisory Responsibilities

• There is little or no supervisory responsibility in this position

Advocacy

Treats all patients and coworkers with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values

• Show We Care, Do The Right Thing, Maximize Individual Potential, Challenge Convention

Qualifications

• Education: High School Diploma or GED is required
• Experience: Three years of medical office experience is required
• Communication and interpersonal skills
• Detail oriented, ability to multi task and ability to work in a fast paced environment
• Knowledge of IR procedures and exams is preferred
• Knowledge of CPT and ICD9 Codes is preferred
• Keyboarding and computer skills
• Anatomy and medical terminology is preferred
• Understanding of all procedures to be read by a Radiologist is preferred
• Computer Skills : Experience with Outlook; Microsoft Office suite; Workday; Imagecast; Stentor; Flowcast; Internet/Intranet, Amazing Charts, Webex
• Background Check :
• Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults
• In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Inland Imaging Clinical Associates, LLC will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG). Employees must not be included on this list.
• Drug Test : Eligible employees must be able to pass a post-offer, pre-employment drug test.

Nuvodia/Inland is an EEO employer...