Pre-Authorization Specialist

HOURS: 40-hours

STATUS: Full-Time, Non-Exempt

SCHEDULE: Monday-Friday, 8-hour shifts between 7am-5pm

LOCATION: Remote

Join our vibrant community at Chesapeake Medical Imaging (CMI) and embark on a journey that not only elevates your healthcare career but also shapes the future of patient care. As a leader in providing unparalleled medical imaging services across Maryland and beyond, we're committed to excellence and innovation.

We're seeking a Pre-Authorization Specialist to join our team. This pivotal role involves various responsibilities, including obtaining information on patient's eligibility status with insurance companies to ensure proper coverage and payment for services—while providing exceptional customer service. The schedule for this position would be Monday-Friday, 8-hour shifts.

By joining our team, you'll have the opportunity to work alongside industry-leading professionals who are committed to making a difference in the lives of our patients. You'll also have access to ongoing training and development opportunities to further enhance your skills and advance your career in healthcare.

Why should you make Chesapeake Medical Imaging your next career move?

• Generous PTO: Comprehensive PTO package, including birthday hours and a floating holiday.
• Retention Bonuses: Monetary and PTO-based bonuses to reward your dedication.
• Work-Life Balance: No on-call schedules or Sunday shifts. Enjoy more free time.
• Flexible Shifts: Various shift options (8, 10, or 12 hours) available, depending on the role.
• Career Growth: Cross-train in various modalities and advance your career.
• Professional Development: Annual allowances for Continuing Education (CE) credits and license renewals.
• Retirement Savings: 401k with employer match to secure your future.
• Company Culture: Join our fun events, including themed contests, regional happy hours, holiday parties, and our legendary Family Crab Feast.
• Holidays Off: Our offices are closed on major holidays so you can recharge.
• Employee Support: Access to our Employee Assistance Program and Dependent Care FSA.

MINIMUM? ?QUALIFICATIONS? ?(KNOWLEDGE,? ?SKILLS,? ?AND? ?ABILITIES)

• Meets time and attendance requirements for the position and uses work hours productively and appropriately. This is a high attendance position.
• Must be able to work independently with minimal supervision.
• General computer and Internet knowledge.
• Accurate data entry skills.
• Provide clear verbal and written communication.
• Ability to multi-task and be organized.

While this position is remote, candidates located in Maryland, Virginia, Washington D.C., or Delaware are preferred. There may be occasional onsite meetings or events at our locations in Maryland that the hire will be expected to attend.

• Supports a collaborative team environment. Creates strong working relationships with insurance groups, patients, referring physicians, Regional Managers, billing department, and imaging center staff.
• Pre authorization process:
  • Real time work list, workload prioritization to obtaining patient authorization prior to the scheduled exam date and time.
  • Verification of patient insurance eligibility.
  • Determining individual insurance plan radiology benefits for scheduled exams.
  • Obtain clinical history from referring physician in order to obtain authorization on a scheduled exam.
  • Provide information from insurance companies and/or review agencies to appropriate staff in an orderly and timely manner.
  • All eligibility, authorization, and determination of benefits information obtained are to be documented appropriately in the patient’s medical record in the RIS.
  • Communicate with patients and/or referring physicians on non-covered benefits or exam coverage issues.
• Utilizes website solutions and all available resources to obtain information on patient's eligibility status with insurance companies.
• Works with patients and referring offices to obtain complete and correct insurance information, discuss eligibility results, and discuss alternative payment methods.
• Properly analyzes various payer eligibility responses to find the information needed to complete the verification.
• Communicates any updates and/or changes in payer authorization requirements.
• Follows all HIPPA, compliance, privacy and confidentiality standards.
• Communicates clearly and effectively in a courteous and professional manner.
• Provides thorough and accurate information to all callers.
• Consistent communications to Clerical Team Manager on progress and potential problem cases to receive direction on how to resolve situations.
• Understand insurance guidelines including Medicare, Private, government and managed care plans.
• Works with the Clerical Team Manager to establish better efficiencies and process improvement
• Supports and cooperates with other imaging center staff and outside billing company regarding pre-authorizations and insurance eligibility
• Performs other related duties as assigned or requested.