• Lifespan Corporation
  • $52,180.00 -81,350.00/year*
  • Providence , RI
  • Advertising/Marketing/Public Relations
  • Full-Time
  • 25 Broadway


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Summary:

Under supervision of the Manager Diagnostic Imaging Support

Services is responsible for the integrity of the pre-registration and prior

authorization processes for outpatient radiological services within

Lifespan. Coordinates and arranges for

all outpatient radiology orders to ensure patients have received financial

clearance from insurance companies and troubleshoot as needed.

Responsibilities:

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Registers patients prior to scheduled appointments to obtain

updated account information for accurate insurance billing.

Confirms patient eligibility with insurance carriers/third

party payors and obtains pre-authorization requirements in accordance with

established medical policies.

Coordinates and ensures appropriate insurance authorizations

are obtained and/or received in a timely manner.

Reviews recognizes and understands clinical documentation

from patient records pertinent to obtaining prior authorization as necessary.

Analyzes orders authorizations and records for

discrepancies that may affect insurance coverage and/or denial of claims.

Notifies and coordinates with ordering physicians and

providers when peer-to-peer discussions are required to obtain prior

authorization of services being denied by patients? insurance.

Professionally communicates with various Lifespan personnel

to resolve billing issues authorization denials and financial clearance of

patient appointments.

Provides mature quality customer service to patients their

families and/or their representatives.

Ensures all patients are financially cleared by insurance/

third party payor prior to their scheduled appointments.

Performs other duties as assigned.

Other information:

BASIC KNOWLEDGE:

High school diploma or equivalent required. Knowledge of

business systems office procedures computer skills medical terminology and

health insurance processes/terminology including but not limited to CPT and

ICD-10 coding.

Strong organizational skills critical thinking and focus to

detail required to manage high volume of radiologic orders requiring prior

authorization and/or financial clearance.

Analytical skills to evaluate effectiveness of work flow

with the ability to make recommendations develop and adapt to changes as

necessary.

Interpersonal skills necessary to provide effective

communication with patients and other healthcare professionals within and

outside of Lifespan.

EXPERIENCE:

Two years of previous experience in health care environment

with emphasis in health insurance billing and reimbursement healthcare

operations database management and patient/ provider interaction.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Normal office environment; may experience some visual

fatigue as result of extended periods of work on the computer.

INDEPENDENT ACTION:

Performs independently within the department?s policies and

practices. Refers specific complex

problems to the supervisor when clarification of the departmental policies and

procedures are required.

SUPERVISORY RESPONSIBILITY:

None.

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.

Location: Rhode Island Hospital USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union



* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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