Authorization Specialist-IR

Base Pay Range:$18.97 - $28.46

Job Description:

The Supplemental Authorization Specialist - IR will fill in for vacation and sick calls at the Holy Family Outpatient Based Interventional Center. Monday-Friday day shift. This position is eligible for a 12% supplemental differential.

Summary:

Coordinates, authorizes, and schedules interventional procedures in a friendly, courteous and professional manner. Interacts with the providers, other departments within Inland Imaging Clinical Associates, patients and their family members and outside contacts.

General Description:

The Authorization Specialist - IR must be able to: work effectively and efficiently in a fast-paced environment in meeting continual deadlines; handle multiple priorities with constant interruptions; be highly organized to meet deadlines. Organizational skills are essential. Interacts with the radiologists, other departments within Inland Imaging, patients and family members and outside contacts. Excellent written, verbal, and personal communication skills; be tactful and diplomatic;

and be highly confidential is required. Makes decisions regarding daily work priorities and other decisions based on company policies and procedures.

Essential Duties/Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Obtains insurance authorization and or verification if required from all insurance payers for interventional procedures and imaging

Verifies patient has insurance coverage and referral in place if needed for office visits/procedures

Interacts with billing department regarding billed procedures/codes/authorizations

Coordinates peer-to-peer conversations between Radiologists and insurance medical directors

Submits clinical documents, case studies and additional information used for appeals

Guides callers from outside offices and facilities on coding, protocols for initiating interventional procedures

Processes inner office mail and emails regarding special cases, stat cases and follow-ups Obtains authorization and schedules all vein procedures including initial pre op instructions and prep Submits orders/H&P/insurance info to outside facilities for scheduling of procedures

Interacts with outside vendor to coordinate information for preauthorization of Y-90 procedures Schedules patient consultations and follow-up exams including diagnostic tests as needed.

Interacts with patients prior to and after exam, communicating authorization for interventional and vein procedures, treatments, outcomes, and possible complications regarding the authorization.

Answers and fields patient phone calls regarding authorization and insurance.

Checks and submits insurance preauthorization forms prior to procedures online

Assures imaging and procedure orders are authorized and distributed in a timely manner

Monitors and follows up on all authorizations and submissions with all insurance payers

Interacts with Radiologists, nursing staff and other staff members to assure prompt quality patient care.

Other projects and duties as assigned

General

Duties and Responsibilities:

Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.

Follows all Health and Safety policies and guidelines of Inland Imaging or its partners depending on work location.

Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.

Follows all policies regarding HIPAA, non-disclosure of…