MRI Verifier

Position Summary:

Primary responsibility is to verify integrity of patient demographics, health insurance coverage and eligibility. Verifies if any type of authorization is required from insurance for the patients MRI and contacts the referring physician to expedite process; this may including starting a case with the insurance or directly obtaining authorization for the exam with clinical information provided by the referring physician.

Essential Functions and Responsibilities Includes the Following:

1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors

2. Pull daily report for verification of all MRI locations

3. Verify and correct demographic information

4. Verify and correct insurance information and verify eligibility of insurance

5. Verify if pre-authorization is required and follow up daily to make certain required authorization is obtained

6. Maintain constant contact with scheduling staff regarding insurance and authorization

7. Contact referring physicians office regarding authorization requirements

8. Follow up on status pertaining to authorization either with the referring physicians office or the insurance carrier

9. Assist the referring physicians office in expediting the approval process. Which can include creating cases or obtaining authorizations for the contracted doctors

10. Act as liaison with the patient/insurance carrier to alleviate any eligibility issues that could affect patients MRI examination

11. Review to make certain authorizations are approved and that the scheduling department and receptionists are aware of any issues when confirm patients appointment

12. Performs all other related duties as assigned

Education& Experience Requirements:

High school diploma/GED required.

Must have general knowledge of typing, computer skills,medical terminology, and CPT billing codes.

Core Competencies:

Team work, adaptability, communication skills, problem-solving skills, planning and organizing,

attention to detail, judgment and decisions making skills, stress tolerance.

Physical/Mental Demands/Requirements & Work Environment:

-Must be able to remain in stationary position 50% of the time

The person in this position needs to occasionally move about inside all of the MRI zones

to access patients and paperwork.

-Constantly operates a computer and other office productivity machinery

-The person in this position frequently communicates with patients who have questions

about their bills/financial obligations. Must be able to exchange accurate information in

these situations.

-Must be able to observe and inspect employees and patients in all of the MRI zones

-Frequently move and position patients for MRI exams

-May be exposed to chemicals necessary to perform required tasks. Any hazardous

chemicals the employee may be exposed to are listed in the hospital’s SDS (Safety Data

Sheet) data base and may be accessed through the hospital’s Intranet site (Employee

Tools/SDS Access). A copy of the SDS data base can also be found at the hospital

switchboard, saved on a disc.