Scheduling and Prior Authorization Representative

McKenzie Health•Watford City, ND

About The Position

The Radiology Scheduling/ Prior Authorization is a patient access representative who is highly knowledgeable in scheduling all exams in all modalities of Radiology. This position works exclusively for the Radiology Department providing excellent customer service, functioning as our frontline representative. This position is trained in and responsible for assisting patients, providers- both MCH and outside, and Radiology staff with all aspects of pre and post scheduling any Radiology needs. This includes checking for labs, prior imaging, competency in PACS applications, contacting insurance companies to properly obtain prior authorizations, providing required up-front collection amounts, etc. The job description for a Radiology Scheduling/ Prior Auth will include accurately recording data and communicating well with members of within the public, outside providers, and others McKenzie Health.

Requirements

Must meet deadlines and manage all assigned projects.
Must have knowledge of insurance verification processes.
Must present professionally in both appearance and demeanor.
Must possess a basic understanding of medical terminology and procedures.
Must be able to perform routine mathematical calculations.
Must always maintain confidentiality and accuracy.
Must possess excellent verbal, written and telecommunication customer service skills in line with our AIDET principles.
Must be proficient in Windows and Microsoft Office Suite.
Must demonstrate independent work initiative, sound judgment and a strong work ethic.
Must work cooperatively in a team atmosphere.
Must be able to multitask while practicing efficient time management.
Must contribute solutions in group settings and be open to feedback.
Must demonstrate basic computer and typing skills.
Must attend all required meetings.
Must be able to pass a background check and drug screening.
High school diploma or equivalent required
Minimum of 1 year in a clerical position.

Nice To Haves

Associates degree preferred

Responsibilities

Greets patients and records pertinent information into a computer database.
Obtains patient’s insurance coverage information, verifies coverage eligibility, obtains required prior authorizations, and explains all deductibles, contracted rates and self-pay deposits.
Obtains and verifies patient guarantor information to ensure that the patient record is up-to-date, accurate and available for billing purposes.
Keeps the most current admission information updated within the system.
Calculates payment information, communicates required payments to the patient and registration staff, accepts phone payments and creates payment plans when necessary.
Provides information to patients regarding North Dakota Health and Welfare services as well as Hospital Financial Assistance programs.
Works in collaboration with providers and other departments to obtain updated patient information as necessary.
Reports all discrepancies and special payment plan requests to the Business Office Manager in a timely manner.
Works collaboratively with Patient Financial Services about special circumstance patients.
Works in an organized, efficient manner to keep a smooth and orderly flow.
Abides by HIPAA, NPP and MCHS guidelines, policies and procedures at all times.
Other duties as assigned.