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PET/CT Coordinator

2 months ago

Owings Mills, United States RadNet Full time $20 - $23
Job DescriptionJob Description

Responsibilities

Schedule: Monday-Friday 9:00am-5:30pm. Must be able to train in-person at Seven Square site for up to 4 weeks.

The PET/CT Coordinator is responsible for assisting with the High Dollar PET/CT program and the PET/CT FDG front end review process. Responsible for obtaining clinical and insurance information on the patient’s and working with the national high dollar teams to ensure proper coverage and payment for services. This person will review PET/CT cases from our front end workflow process to ensure proper coverage and payment for services. This person works closely with RADNET MD PET schedulers, insurance providers and referring physicians’ staff to obtain medical necessity documentation and patient history and notes in order to expedite processing.

Essential Duties and Responsibilities

  • Verifies eligibility & benefits for primary & secondary insurances referred for costly PET & Nuc Med isotopes - Medicare/Secondary policies, PPO & HMO plans.
  • Follows authorization and/or pre determination status for pending PPO & HMO costly PET & Nuc Med isotopes and coordinates with the referring office when additional clinical or peer to peer is required
  • Assists obtaining clinical documentation for PET/CT exams to submit with the claim to expedite payment from Medicare & PPO insurance plans.
  • Verifies eligibility and authorization for PET & nuclear medicine costly isotope A-codes for authorized Pet & nuclear medicine procedures including accurate, timely, and thorough documentation and completion of all necessary paperwork, according to established standards.
  • Reviews clinical information from PET schedulers to determine medical necessity and coverage criteria.
  • Ensures accurate and timely data entry into the RIS system for each patient, according to established standards.
  • Works with patients, physicians & referring offices to obtain complete and correct insurance information, discusses eligibility results and alternative payment methods.
  • Obtains and confirms insurance pre-authorizations when necessary.
  • Training new employees holding roles on this team.
  • Follows all HIPAA, compliance, privacy and confidentiality standards.
  • Maintains patient confidentiality at all times.
  • Demonstrates professionalism and courtesy to patients, families/guests and other team members.
  • Communicates clearly and effectively.
  • Communicates with vendors, patients, referring physicians, co-workers and all team members in a courteous and professional manner.
  • Provides thorough and accurate information to all callers.
  • Maintains self-control when dealing with difficult patients and/or situations. Involves manager or team leader when necessary.
  • Maintains log of accounts/procedures verified.
  • Works closely with referring physicians’ staff to obtain patient notes and begin process of authorizations.
  • Scans all completed paperwork into eRad RIS.
  • Completes all paperwork in a timely and accurate manner.
  • Promotes a positive and supportive relationship with referring community and fellow employees.

Requirements:

  • A high school diploma or general education degree (GED)
  • One to three years of Nuclear Medicine and/or PET/CT scheduling experience.
  • Familiarity with Radiology Information Systems (preferably eRad).
  • Possesses and utilizes excellent customer service skills, strong public relations skills, and exceptional written and verbal communications skills.
  • Must be detail-oriented and organized, possess clerical skills, and have the ability to interact effectively with doctors, referring doctors and staff, patients, vendors, peers, and management.