What are the responsibilities and job description for the BENEFITS AND ELIGIBILITY / PRIOR AUTHORIZATION M-F (8-5 PM) position at Oregon Advanced Imaging LLC?
JOB DESCRIPTION
Summary Description:
Verifies patient insurance and eligibility prior to the exam WITH Prior Authorization experience. Interfaces with referring physician offices and insurance companies to make sure eligibility and estimates are in place prior to the patient's exam. This position is classified as non-exempt under FLSA.
Essential Functions:
1. Reports to work as scheduled and on time per policy with predictable regular attendance. Time away from work is approved and taken in accordance with established policies.
2. Takes all reasonable steps to maintain the confidentiality of all information related to patients, medical staff, employees, and as appropriate, other information, ensuring compliance with HIPAA mandates.
3. Demonstrates positive interpersonal communication in dealing with all others. Recognizes and respects differences in the workplace. Demonstrates openness, sensitivity, and commitment to coworkers, patients, family members, and any other visitors to OAI.
4. Consistently demonstrates and incorporates principles of safety and infection control into daily activities. Uses protective equipment and takes appropriate precautions whenever there is potential contact with blood, body fluids, and/or chemicals. Maintains current knowledge of disaster policies and participates appropriately in disaster drills. Expresses principles of body mechanics to prevent injury and accidents.
5. Displays consistent commitment to customer service and teamwork. Displays personal behavior that has a positive impact on the team.
6. Demonstrates personal commitment to staying current in the field of knowledge, expanding knowledge and skill, and contributing to organizational success.
7. Displays the ability to work in an ever-changing environment and participate constructively in change processes.
8. Attends staff meetings, and completes education programs as requested or approved by OAI.
9. Prepares patient responsibility estimates and enters all applicable documentation and notes in RIS prior to the scheduling of the scan.
10. Works with patients who have a collections alert in setting up payment at the time of service (TOS) or payment arrangements.
11. Provides Care Credit support to patients.
12. Mail, process, and communicate the outcome of financial assistance applications to patients; communicates to appropriate staff when a patient is to receive financial assistance.
13. Responds to many incoming telephone calls and communicates professionally, demonstrates good telephone skills, and works well with patients, physician’s office staff, and physicians.
14. Provides support to the pre-authorization team as needed.
15. Performs other related duties as requested.
Qualifications:
1. High School graduate/GED required.
2. Extensive knowledge of medical terminology.
3. Excellent communication and customer service skills required. Proper English grammar skills are required, including speaking, reading, and writing.
4. 2 years of radiology experience preferred.
5. Experience working with Radiology Information Systems (RIS) preferred.
6. Must have excellent communication skills, be pleasant, cooperative, and practice good public relations at all times.
7. Able to meet the mental and physical demands of this position (see ADA Form).
8. Must possess excellent computer skills.
Employee Signature: _______________________ Date; _____________________
