Imaging Services Representative

Catholic Health•Melville, NY

About The Position

The Imaging Services Representative manages incoming and outgoing calls for Catholic Health’s Radiology service line and supports access to and throughput of radiology services. The role schedules appointments, gathers demographic and financial information, verifies insurance coverage and benefits, explains patient financial responsibility, and secures service authorizations. Representatives communicate applicable policies, protocols, and appointment instructions to provide a positive patient experience. The position performs patient registration, scheduling and preregistration, insurance verification, and authorization-related work using Epic and other online eligibility and precertification systems. It coordinates with patients, responsible parties, financial counselors, physician offices, the Financial Clearance Center, and Patient Access Services staff to ensure orders and accounts are accurate and appropriately cleared before service where possible. The role also protects confidential information and follows Catholic Health’s policies and core expectations.

Requirements

High school diploma or equivalent experience.
At least 1 year of experience in Revenue Cycle Management or Patient Access Services functions.
Comprehensive understanding of insurance, precertification requirements, and medical terminology.
Ability to access online insurance eligibility and precertification systems.
Customer-focused approach and strong interpersonal skills, courtesy, and tact when interacting with patients, family members, physicians, and staff.
Strong problem-solving skills and ability to interpret and execute policies and procedures.
Ability to protect patient confidentiality and the confidentiality of hospital and departmental documents.
Working knowledge of personal computers and standard office equipment.
Positive demeanor and good verbal and written communication skills; professional appearance and approach.
Ability to handle potentially stressful situations and multiple tasks simultaneously.
Ability to successfully complete additional job-related training when offered.

Responsibilities

Manage incoming and outgoing calls for the Catholic Health Radiology service line.
Use assigned workqueues, workdrivers, and reports to complete daily tasks.
Interview patients to verify or obtain demographic, insurance, employer, and encounter information, and document information in Epic.
Contact patients to coordinate appointments and complete scheduling and preregistration in Epic according to department guidelines and insurance parameters.
Communicate relevant appointment instructions, policies, and protocols to patients.
Verify insurance eligibility, active coverage, benefits, network status, coverage limitations, and patient liabilities; document findings.
Confirm whether precertification or authorization is required, review applicable clinical documentation and payer criteria, and obtain initial and subsequent authorizations as appropriate.
Explain expected out-of-pocket expenses, including deductibles, copayments, coinsurance, and non-covered services; use the procedure estimate process to notify patients of amounts due.
Collect applicable copayments, coinsurance, deductibles, and self-pay fees before or at the point of service; document collections and provide receipts.
Refer patients to financial counseling when appropriate and inform supervisors of services that may be at financial risk.
Coordinate with financial counselors, physician offices, patients, the Financial Clearance Center, and Patient Access Services staff to ensure accurate orders and appropriate authorizations.
Maintain knowledge of scheduling guidelines, facility structure, payer regulations, collection policies, and changes to Medicare, Medicaid, and third-party payer reimbursement requirements.
Follow medical necessity protocols and use the Compliance Checker and National Coverage Decisions appropriately.
Use analytical and problem-solving skills to address issues and propose ideas to improve operational efficiency.
Protect confidential patient, employee, and organizational information in accordance with Catholic Health policies.
Perform other duties as assigned.