Job Description

Join a great team!

Derry Imaging is seeking an experienced Pre-Authorization Specialist who will promote a culture of excellence in patient service. This is a full-time position located in Windham, NH. T his is NOT a remote position.

The Pre-Authorization Specialist’s core duties consist of contacting insurance companies and other third-party administrators to determine pre-authorization and/or medical necessity requirements for basic and high-tech outpatient radiology exams and procedures. The successful candidate liaisons with patients, physicians and physician office staff as needed to obtain clinical documentation.

Key Responsibilities Include:

• Validating insurance eligibility and communicating with patients and provider offices to ensure accurate insurance information has been obtained for the radiology services ordered
• Contacting insurance companies and third-party administrators to determine prior authorization necessity and follows proper procedures to secure valid authorization and approval for ordered procedures in a timely and efficient manner
• Communicating with radiology scheduling department as needed
• Validating all authorizations for ordered radiology tests and appropriately documenting these approvals in the patients’ electronic record
• Reviewing any radiology claim denials for lack of authorizations to determine the root cause and appeal any inappropriate denials in a timely manner
• Working closely and collaboratively with providers, clinical staff, and managers

Additional Requirements:

• Provide excellent customer service to Derry Imaging’s patients, family and/or caregivers, as well as all employees and associates
• Maintain the confidentiality of patients’ personal medical and financial information at all times
• Actively engage in all training and education activities related to role
• Perform job duties in a manner that reflects the highest ethical and professional standards
• Ensure and protect the confidentiality of sensitive information by following HIPAA Guidelines
• Comply with all federal, state, and local standards and laws regulating the provision of professional services
• Independently manage workload for pre-authorization review of submitted radiology orders to ensure that the necessary pre-authorization is obtained accurately and swiftly so that patients can be scheduled for their radiology procedures as quickly as possible
• Treat all employees, visitors, and patients with respect and compassion

Education and Experience:

• High school diploma/GED is required
• A minimum of two years’ experience performing Prior authorization for medical services is required

Full Time Positions at Derry Imaging Offer:

• Paid time off
• Competitive pay
• Comprehensive health, dental, prescription, and vision benefits
• Company-paid short-term disability, long term disability and life insurance coverages
• 401k

Derry Imaging Center is American College of Radiology (ACR) accredited in Mammography, Ultrasound,  MRI and CT Imaging, and has onsite fellowship-trained radiologists. Offices are located in Bedford, Concord, Derry, Dover, Londonderry, Raymond, and Windham. For more information, please visit .

We are an equal opportunity employer embracing the strength that diversity brings to the workplace. We provide a welcoming and supportive environment for employees of all ethnic backgrounds, cultures, ages, lifestyles and physical abilities.

 

Job Tags

Full time, Temporary work, Local area,

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