Pre-Authorization Specialist

3 months ago

East Brunswick, United States University Radiology Full time

Overview:

Sign-on Bonus Now Being Offered to Eligible New Hires**

University Radiology, the largest provider of subspecialty radiology and teleradiology services in NJ, is comprised of over 180 Board Certified radiologists with advanced U.S.-based training and expertise in all modalities and all subspecialty areas. In operation for more than 60 years, University Radiology staffs, manages and provides preliminary and final subspecialty interpretations and consultative support for hospitals, imaging centers and other medical facilities, and serves as the academic radiology faculty at Rutgers Robert Wood Johnson Medical School. Our physicians interpret over 2.1 million radiology procedures per year.

Responsibilities:

University Radiology is looking for a full-time Pre-Authorization Specailist for our East Brunswick, NJ Business Office.

  • Responsible for obtaining required paperwork necessary to meet each insurance companys requirements, and verifying the accuracy of the paperwork before and after submission
  • Request, follow up and secure prior-authorizations prior to services being performed. Contact payer to obtain prior authorization. If needed, gather additional clinical and or coding information, as necessary, in order to obtain prior authorization
  • Successfully works with payers via electronic/telephonic and/or fax communications
  • Collaborates with designated clinical contacts regarding orders that require escalation to peer-to-peer review
  • Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner. Utilize registration system notes to document important information related to verification, pre-cert, and upfront collection
  • Meet/exceed performance standards/productivity of 40 45 daily preauthorization submissions
  • Communicate all challenges, potential impact the challenge may have on the department and possible solution(s) to the management team
  • Provide excellent customer service to Physician Referral Organizations, internal team members and patients
Qualifications:
  • A Knowledge of CPT/ICD9/ICD10
  • Requires effective customer relation skills, ability to organize and interpret data
  • Requires good judgment, tact, diplomacy, and ability to problem solve
  • Good time management skills, avoiding unnecessary stress
  • Must have excellent verbal and written communication skills
  • Must be able to work in a high call volume and fast pace work environment
  • Knowledge of all insurance contracts & reimbursement
  • Knowledge of Insurance Websites
  • Ability to learn quickly and accurately
  • Must work independently but also able to work effectively in a team environment
  • Must be self-motivated showing interest to self-improve
  • Effective at meetings - providing feedback, ideas and suggestions to improve daily work flows
  • Excellent computer skills


Benefits:

University Radiology offers a comprehensive benefits program including medical, dental and life insurance, 401k/pension, and profit-sharing plans, generous paid time off policy and more.

Join our growing team

University Radiology is an Equal Opportunity Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

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