Precertification Specialist

Job Description

Job Description

Join Our Team at ImageCare Radiology!

At ImageCare Radiology, we offer a wide range of diagnostic imaging services across 20+ locations in Northern and Central New Jersey. Our outpatient centers provide affordable, high-quality care in a patient-focused environment. Join our growing team and help us deliver exceptional medical imaging while advancing your career in a supportive, dynamic setting. Be part of a team that values your skills and contributions!

Schedule:

Monday-Friday 9:00am - 5:30pm

We are seeking a Precertification Specialist for an immediate full-time position at our Hackettstown location. All new hires are required to attend first-day orientation at our Mount Olive office before reporting to their assigned work location or training site.

The candidate must be experienced with all aspects of insurance verification and the authorization process for medical testing. The candidate must also be familiar with all forms of commercial insurance plans and third-party websites like Evicore and Navinet. Employees in the Precertification department must be motivated, organized, and team players with a positive attitude.

GENERAL DESCRIPTION OF POSITION
Responsible for verifying insurance on our schedule and obtaining pre­ authorizations as needed.

Duties Include but not limited to:

Must be familiar with our codes, "Red" (requires immediate attention and review) and "Green" (approved status) on RIS scheduler.

1. Verifies all insurance coverage on the schedule that is in Red, adjusts to Green after study is verified to completion by the close of each business day.
2. Verification includes any and all in-network and out-of-network facilities, and Medicare
3. Obtains precertification for physician's office if applicable
4. Determines patient qualification for coverage and notes patient accounts respectively.
5. Maintains current list of facility insurance precert agreements.
6. Responsible for entering any missing data by schedulers (ie: Bloodwork, screening questions etc.)
7. Inform Kathy of any changes required in obtaining pre-authorizations in order to update and keep accurate the Pre-Certification manual
8. Versatile and willing to coordinate with and participate in, when necessary, all other aspects of our other Business Offices and locations
9. Performs other duties as assigned and deemed necessary by management

1. Maintain HIPAA practices and HIPAA training

Management: Responsible for enforcing all duties declared, preparing monthly reports for managers meetings and appropriately staffing department as needed and approved by supervisors.

BENEFITS:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

ABILITY TO RELOCATE/COMMUTE:

• Hackettstown, NJ 07840: Reliably commute or planning to relocate before starting work (Required)
  

Flu Vaccination & Proof of MMR Requirement:
It is ImageCare's Company Policy that all personnel must be vaccinated with the MMR and the yearly flu shot.

ImageCare Centers provided the following inclusive hiring information: We are an equal opportunity employer and consider all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.