Provide pre-certification for imaging services for ColumbiaDoctors Radiology offices. Collect and verify patient’s insurance coverage, pre-certification requirements of patient’s insurer, update IDX registration, prepare and complete paperwork in preparation for patient’s imaging.
Efficiently and pleasantly work with referring physician offices; providing pre-certification services for referring physicians offices.
Obtain all relevant patient clinical/demographic data from referring physician office and or EHR system.
Communicate with all parties including referring physician, Radiology and billing vendor regarding updated status of pre-certs.
Inform referring physician offices when pre-certifications are denied and work with the office to appeal the denied pre-cert.
Remain knowledgeable of pre-certification requirements for all insurance plans. Assist in maintaining records/protocols as third party rules and guidelines are changed or modified.
Using web-based third party networks as well as telephone contact, obtain pre-certification for referring physicians. Review pre-certifications confirming that all studies are correctly pre-certified.
Schedule appointments for Radiology clinical practice sites.
Communicate directly with technologists, radiologists and front desk to ensure seamless communication related to referring physician office requests.
High School Diploma, College preferred
Minimum three years of physician billing experience. Practice; IDX medical billing and scheduling experience essential, Radiology experience preferred; excellent interpersonal and communication skills