Desert Radiologists Prior Auth Coord in Las Vegas, Nevada
Prior Auth Coord
2020 Palomino Lane, Las Vegas, NV 89106, 2020 Palomino Lane Suite 100, Las Vegas, Nevada, United States of AmericaReq #1194
Tuesday, January 26, 2021
Desert Radiology is committed to serving patients with prompt, quality healthcare. Founded in 1966, Desert Radiology has grown with the Southern Nevada community to become the area’s chief resource for the highest quality diagnostic care. Our staff of radiologists, technical and support teammates promote a reassuring environment that relieves concerns and results in the best possible experience for our patients. Desert Radiology works closely with local area hospitals to deliver leading-edge diagnostic and interventional imaging. We are proud to partner with numerous Nevada hospitals. It is the combination of compassion, expertise and a commitment to providing the latest imaging technology that makes Desert Radiology the premier choice for outpatient imaging procedures.
Desert Radiology in Las Vegas, Nevada is seeking a Prior Authorization Coordinator that will facilitate all prior authorization requests submitted by referring physician offices.
POSITION DUTIES AND RESPONSIBILITIES
- Receives prior authorization requests from the physician’s office and completes the following processes:
§ Reviews the referral for accuracy and ensures all necessary data is included.
§ Contacts referring physician’s office if additional information is needed.
§ Reviews clinical notes and extracts all pertinent information.
§ Inputs and verifies all data and patient demographic information into radiology information system (RIS) and places patient on the call list for exams to be scheduled.
- Facilitates the receipt of the prior authorization by completing the following processes:
§ Contacts the insurance company, either by telephone or via the internet, to determine patient’s eligibility.
§ Obtains authorization from the insurance company by providing CPT and ICD-9 codes and clinical information.
§ Conducts appropriate follow-up, on a daily basis, on all pending authorizations until final determination has been made.
- Provides timely communication throughout the prior authorization process by:
§ Communicating authorization denials to the referring physician’s office.
§ Communicating authorization approval to the referring physician’s office.
§ Notifying the Scheduling Department if a scheduled exam is denied.
Accurately documents all information and communications, verbal and written, with the patient, provider or insurance company, into the radiology information system (RIS).
Answers all incoming calls from referring physicians, coworkers, and patients, in a pleasant and timely manner.
Identifies prior authorization-related issues. Communicates appropriately to the PCC Supervisor regarding these and/or other departmental issues.
DESIRED PROFESSIONAL SKILLS AND EXPERIENCE
Knowledge of CPT and ICD-9 coding, authorization and eligibility practices and paperwork processing requirements
Knowledge of medical terminology
Knowledge of eligibility software
Knowledge of and experience in using office equipment including telephone, fax, computer, adding machine and photocopier
Knowledge of and experience in using radiology-related computer systems (RIS)
Knowledge of customer service concepts and techniques
Ability to process authorization for an average of 30-35 exams per day
Ability to understand clinical notes
Ability to perform basic mathematical computations
Ability to pay close attention to detail for extended periods of time
Ability to apply good judgment and problem solving skills
Ability to communicate clearly in person and on the telephone
Ability to use interpersonal skills to effectively interact with physicians, other facility staff, patients and families when providing instructions, responding to questions or exchanging patient-related information
Ability to organize and prioritize tasks effectively
Ability to read, understand and follow oral and written instructions
Ability to file correctly by alphabetic or numeric system
Ability to maintain confidentiality of patient record information
Strong customer service skills and the ability to keyboard proficiently
Previous experience in insurance eligibility
Previous experience in prior authorization
CPT and ICD-9 coding experience
PHYSICAL AND MENTAL DEMANDS
Position requires sitting for six to seven hours per day; eye-hand coordination and finger dexterity; ability to view computer screens for long periods. Position may be stressful at times due to workload and/or dealing with difficult patients.
Radiology Partners is an equal opportunity employer. We believe in creating and celebrating a culture of belonging and are committed to creating an inclusive environment for all teammates.
Job Family5B Support Staff – Pt Svcs, PCC, Support Svcs
- 2020 Palomino Lane, Las Vegas, NV 89106, 2020 Palomino Lane Suite 100, Las Vegas, Nevada, United States of America