Insurance Specialist Insight Health Corp.
Insight Imaging partnered with Center for Diagnostic Imaging (CDI) in 2012 to create one of the nation?s largest radiology providers for fixed site and mobile diagnostic imaging and interventional services. Together we have 116 retail imaging centers, 128 mobile units and operate in more than thirty states. Our organization served nearly a million patients in 2013, offering a wide range of screening, diagnostic and interventional procedures that complement each community?s needs, in collaboration with radiologists, healthcare providers, hospitals and health systems.
We are currently seeking a full-time, Insurance Authorization Coordinator to join our Los Gatos, CA center.
Under close supervision, obtain workers compensation and private insurance authorizations for regional centers; work with referring physician to obtain appropriate paperwork for authorization; and perform other related duties as needed.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Handle telephone calls with worker?s compensation adjusters and fax Utilization Review (UR) to obtain authorizations for scans.
Handle telephone calls with private insurance companies on behalf of referring physician to obtain authorization for prescribed scans.
Notify referring physician?s office of status for pending and denied authorizations.
Ensure that all paperwork is sent to imaging center when appropriate imaging procedure has been authorized; follow-up with email confirmations.
Assist center Account Executives in promoting the authorization by cold-calling and lunch presentations.
Handle telephone calls with patients, physician offices and insurance companies in regards to any authorization issues.
Input patient demographics, billing data, and notes into the IRIS system.
Work with Area Director, Enterprise Development to obtain insurance contracts.
Comply with all applicable laws, rules and regulations, the company?s policies and procedures, and The InSight Integrity Program.
Perform other projects/tasks, as requested by the Company.
COMPETENCIES (KNOWLEDGE, SKILLS, AND ABILITIES) REQUIRED:
Basic medical terminology.
Read and interpret insurance plan coverage.
Basic typing and computer knowledge.
Customer service principles and techniques.
Office filing and record keeping techniques.
Communicate effectively with staff, management, vendors, contractors, healthcare representatives, government regulators and external customers
Handle telephone calls using proper telephone etiquette
Operate standard office equipment such as calculators, typewriters, copiers and facsimile equipment
Schedule, organize and complete work in accordance with deadlines and time constraints
Verify, copy, fax and distribute documents and messages.
Maintain confidentiality of patient records
Demonstrate appropriate problem solving and decision making.
High school graduate or equivalent
Two years experience in health care/radiology environment dealing with insurance companies
One year dealing with workers compensation insurance - preferred
We are committed to quality, advanced imaging services, subspecialty radiologists and thoughtful, patient-centered care. Looking to the future, we know that our associates are the key to our company?s growth and success. No matter the individual role, each one of our associates excels in applying their talents and ideas to meet organizational goals.
If you?re a person who is motivated to go above and beyond, inspired by working with the best and compelled to do the right thing, our organization is the right choice for you.
Insight Imaging is an equal opportunity employer; applicants are considered without discrimination with regard to race, color, religion, sex, national origin, age, disability, veteran status or other statuses protected by state, local or other applicable laws. This policy extends to all aspects of employment, including recruitment and hiring.
Insight Imaging and its associates have an employment relationship, which is known as employment-at-will. This means that either the company or an associate has the right to terminate the employment relationship at any time, for any reason with or without cause or prior notice.
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