Imaging Services Representative - Part Time

Imaging Services Representative - Part Time

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The part‑time Scheduling Representative is responsible for managing incoming and outgoing calls for Catholic Health Radiology service line. They will support the Catholic Health system by scheduling and collecting all necessary demographic and financial information to ensure streamlined access to care and throughput for radiology services. The Representative will ensure the patient has active insurance coverage, collect demographic information, acquire and explain benefit information, confirm patient responsibility amounts, and secure authorization for services.

They will communicate policies, protocols and instructions relevant to the service being scheduled, providing a positive patient experience.

• Utilize work queues/workdrivers and reports as assigned by management, to complete daily tasks
• Interview patients to verify and/or obtain demographic, insurance, employer and general encounter information
• Confirm with the patient/responsible party the need for pre‑certification and/or authorization for tests
• Document in Epic
• Notify patient or patient representative of expected out‑of‑pocket expenses (deductible, copayment, non‑covered service) and request payment while the patient is on the phone
• Educate patient of pertinent policies, protocols and instructions as necessary
• Confirm initial and subsequent authorizations
• Utilize analytical, problem‑solving skills to determine the best course of action and resolve any problems; keep Supervisor informed of potential services at financial risk

• Propose innovative ideas and solutions to enhance operational efficiencies
• Maintain knowledge of scheduling guidelines, facility structure and navigate situational responses
• Validate that appropriate demographic, clinical and financial information has been collected to ensure excellent patient experience
• Comply with Medical Necessity protocols and use Compliance Checker and National Coverage Decisions
• Maintain knowledge of payer regulations and collection policies
• Stay abreast of changes in Medicare, Medicaid and third‑party payer reimbursement requirements
• Perform other duties as assigned

• Contact patients to coordinate scheduling of appointments for various services and complete scheduling process in EPIC
• Collect necessary data to create a complete and accurate preregistration for scheduled appointments
• Verify insurance activity via insurance eligibility systems to confirm active status
• Communicate with Financial Counselors, physician offices, patients, Financial Clearance Center and PAS staff to ensure accuracy of orders and securing appropriate authorizations
• Follow department‑specific scheduling guidelines and insurance parameters when scheduling appointments
• Appropriately communicate any relevant appointment instructions to patients

• Confirm patient’s health insurance(s) is active and covers the procedure; may be completed multiple times before, during and after a visit
• Document insurance benefits and coverage, including effective date, product line, coverage limitations/requirements and patient liabilities
• Check benefits to determine deductible, coinsurance and copayment amounts due
• Use procedure estimate process/program to notify patient of amount due
• Make patients aware of financial obligations and refer them to financial counseling when necessary
• Collect co‑payments, co‑insurance, deductible and self‑pay fees prior to or at the point of service; document collections and provide receipt
• Verify patient’s network status and communicate if out‑of‑network applies
• Ensure payer requirements are met: verify and document eligibility, confirm and document benefits, review clinical documentation to ensure services are appropriate, analyze visit information to determine authorization needs and secure authorization to clear account prior to service where possible

Incumbents may have access to confidential patient, employee and/or organizational…