Patient Accounts (Authorization team)

Dakota Radiology; Rapid City (SD); On-site; USD 32,000 - 45,000; Full time

Benefits offered by this job

M-F day shift

Job summary

Dakota Radiology is seeking a friendly, patient-focused team member to join our outpatient clinic in Rapid City. The role involves obtaining and validating insurance preauthorization, ensuring documentation is complete in the EMR prior to study dates, and maintaining medical necessity per regulatory requirements.

You will interact with patients, providers, and payors, perform billing inquiries, and provide accurate Good Faith Estimates for self-pay patients, while supporting a dynamic clinic

Qualifications

• Proficient in Microsoft Office and medical terminology.
• Experience with medical clinic preauthorization processes is preferred.
• Ability to obtain and document preauthorization in EMR prior to exam.

Responsibilities

• Document patient interactions in EMR (EPIC) with accuracy and compliance.
• Contact referring providers and insurers to validate and obtain preauthorization.
• Verify orders for accuracy: patient name, exam, diagnosis, referring provider signature.
• Handle incoming/outgoing calls and verify patient information before exams.
• Provide Good Faith Estimates to self-pay patients and communicate to patient/guardian.
• Take payments and respond to billing inquiries to resolve issues.

Skills

Microsoft Office

Medical terminology

Phone handling

Verbal communication

Preauthorization coordination

Education

High school diploma

Tools

EPIC

CMS payor websites

ICD-10/CPT codes

Job description

• Location 2929 5th Street,Rapid City, SD, 57701,United States
• Employee Type Non Exempt FT
• Required Degree High school
• Manage Others No

Description

Dakota Radiology is seeking a new team member to join the team as we expand the clinic.

Looking for a friendly, dynamic, patient focused team member to work in our outpatient clinic helping patients get their medical imaging exams completed as soon as possible. This requires knowledge in obtaining insurancepreapproval / preauthorization based on the patients' insurance information and the ordering physician's exam order. You and the team work to obtain and validate the preauthorization is in the EMR prior to the study date and all documentation is obtained to meet medical necessity.

• Documentation of patient interactions will be completed in the patient’s electronic medical record within EPIC. Providing high quality and accurate work to maintain compliance with all regulatory requirements.
• Contacting the referring providers and insurance companies for preauthorization validation and patient benefits. If preauthorization is required, ensure we have that in place prior to the time of the patient exam. Verify that orders are correct – Quality Check includes correct patient name, correct exam, correct diagnosis, and referring provider signature.
• Take incoming and outgoing calls as needed to complete daily work tasks.
• Meet or call patients needing verification of information prior to the exam.
• Provide an accurate Good Faith Estimate (GFE) to patients who are self-pay and communicate the estimate to the patient or guardian.
• Maintain flexibility in work hours and seating location to meet the company needs. Currently M-F day shift
• Take payments from patients in person or on the phone.
• Answer billing inquiries to provide the caller with answers and resolution to their concerns.

Experience or Job Knowledge:

• Computer experience with proficiency in Microsoft products
• Fluent in medical terminology.
• Previous Medical Clinic Office/ pre-authorization experience for medical imaging preferred
• Utilize online management of CPT and ICD-10 codes via CMS and other payor websites.
• Prior experience in EPIC, preferred.

Education or Certification Requirements: