Insurance Resolution Representative

RadNet • Ballenger Creek, MD

5d

About The Position

Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, RadNet is Leading Radiology Forward. With dynamic cross-training and advancement opportunities in a team-focused environment, the core of RadNet’s success is its people with the commitment to a better healthcare experience. When you join RadNet as our Insurance Resolution Representative, you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators achieve the best clinical outcomes.
JOB SUMMARY
The Insurance Resolution Representative is responsible for handling all assigned inquiries from our Infinx team on active patient accounts. The AT Infinx Returns Representative will utilize their investigative skills to solve for a variety of authorization and eligibility scenarios. This person will confidently navigate RBM/carrier portals to research and resolve outstanding issues, as well as referencing all available RadNet resources. This representative will pursue missing information that is key to the authorization and/or eligibility process and will be innovative in their investigative methods. The AT Infinx Returns Representative will be highly confident speaking with both patients and referring provider offices, providing clear communication and account ownership to ensure the goal of account resolution is quickly achieved.

Requirements

• High School Diploma or equivalent required.
• Bachelor’s degree in business, healthcare, or a related field preferred.
• Previous experience working on authorizations or in radiology preferred.
• Previous experience in a phone and/or customer experience/support role preferred
• Strong interpersonal skills.
• Strong investigative and analytical skills.
• Ability to handle inbound and outbound phone calls in the English language fluently.
• Knowledge and ability to navigate office equipment (such as computer) and understand computer applications such as Word, Excel, Outlook and webchat.
• Ability to scan and label documentation into a patient’s chart.
• Ability to demonstrate and understand eFax protocol.
• Ability to type accurately with precise data entry skills.
• Ability to problem solve and handle multi-tasking in a fast-paced environment.

Nice To Haves

• Maintain departmental Quality Index (QI) and productivity standards.
• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism and integrity, and exercise confidentiality in all areas of performance.
• Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.
• but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.

Responsibilities

• Own incoming inquiries from the Infinx Team on patient accounts where inaccurate or missing information has halted the authorization and/or eligibility process.
• Ability to understand the assigned issue(s) with ease and identify solutions for a variety of authorization and eligibility scenarios that have stalled the authorization and/or eligibility process.
• Investigate and obtain the necessary information through various platforms and communication methods.
• Effectively communicate with patients and referring providers to obtain the key information required to move forward and avoid delays/cancellations.
• Accurately update assigned accounts in RIS while quickly maneuvering between RIS, RBM/carrier platforms, and all communication methods.
• Log all scheduling errors impacting the workflow through the patient experience portal.
• Provide clear and concise account status notes in RIS, as well as any pertinent communication that occurs with our constituents.
• Communicate effectively and efficiently on all account scenarios to management, site leadership, patients, referring providers and peers.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees