Precertification Radiology Liaison - Mount Kisco, NY

UnitedHealth Group • Mount Kisco, NY

124d • $16 - $33 • Hybrid

About The Position

Optum New York, (formerly Optum Tri-State NY) is seeking a Precertification Radiology Liaison to join our team in Mount Kisco, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

Requirements

• High School Diploma / GED
• Must be 18 years of age OR Older
• 6+ months of experience with prior authorizations
• 2+ years of experience in Customer Service
• Experience with Microsoft Word, Excel (create, edit, save documents and spreadsheets) and Outlook (email and calendar management)
• Knowledge of ICD-9 and CPT codes
• Ability to work any of our 9-hour shift schedules during our normal business hours of 8:00am - 6:00pm with a 1-hour lunch. It may be necessary, given the business need, to work occasional overtime

Nice To Haves

• Experience working within the health care Industry and with health care insurance
• Experience working in a hospital, physician's office or medical clinic setting
• A clerical or administrative support background
• Experience working in a call center

Responsibilities

• Review all Radiology advanced imaging schedules for all locations minimum 2-3 days prior.
• Follow up on all missing/pending exams and compile a list to send to the authorization team.
• Review authorizations for validity including expiration date.
• Update the missing/outstanding lists for all sites.
• Obtain all authorization information for exams ordered by outside providers & add/update authorization information appropriately once obtained.
• Communicate clearly with patients to update them on the status of their authorization.
• Answer patient authorization inquiries.
• Manage all upgrade/downgrade requests sent by Radiology technologists.
• Work with appropriate staff to obtain authorizations for sessional providers.
• Obtain contracted rates for patients when necessary.
• Provide Radiology team with exam cost and ABN's for self-pay patients.
• Manage each site's stat radiology requests.
• Forward stat notifications to designated precert rep.
• Work to fill gaps in radiology schedules when appointments are cancelled due to pending or denied authorizations.
• Facilitate solutions to problems/issues.
• Process diagnoses changes.
• Perform other various related duties as necessary to assist in patient care.
• Assist with special projects & tasks.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees