Radiology Authorization Specialist

Radiology Authorization Specialist

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

As our Pre-Authorization Radiology Specialist, you will bridge the gap between physician offices, insurance carriers, and radiology clinics so they can ensure seamless patient care and guaranteed payment for services.

Every day you will verify patient eligibility and secure authorizations for radiology exams. You will be expected to manage the complexities of insurance requirements, ensuring that every service is perfectly aligned with the correct CPT and ICD-10 codes.

To be successful in this role, you will need strong organizational skills, a deep understanding of medical billing and insurance verification processes, and the ability to navigate multi-departmental workflows within an Authorization Department.

As a remote employee, we will provide you with the equipment needed to work from home, including a laptop, docking station, dual monitors, and accessories. This position is work from home within California.

The Pre-Authorization Specialist is responsible for scrubbing their assigned modality/Imaging Center to ensure each appointment has been verified as described below.

• Verify insurance is active and eligible to be seen at DHAI
• Confirm with insurance Carrier if Authorization is required for scheduled exam
• Submit and obtain necessary Authorization for correct CPT code
• Confirm scheduled exam matches the referral/CPT Code/Authorization
• When Peer to Peer is needed provide the RMD the necessary insurance contact information along with the necessary patient information needed for Authorization approval.

Required:

• High School Graduate General Studies or High School GED General Studies
• Proficiency in health insurance eligibility and authorization requirements
• Knowledge of government program regulations, Medi-Cal, Medicare, MIA, C.C.S., and other third party payers
• Ability to problem solve; ability to analyze data and recommend changes
• Must have strong customer service skills
• Ability to work collaboratively with a culturally diverse staff and patient/family population
• Ability to work independently with minimum supervision
• Must have basic PC skills
• Medical Terminology - basic knowledge
• Excellent Oral/Written Communication Articulate and concise oral communication
• Ability to write clearly and concisely

Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona, and Nevada. Today Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled qualities that are vital to maintaining excellence in care and service. Dignity Health Medical Group North State a service of Dignity Health Medical Foundation is a multi-specialty clinic with eleven locations in Redding and Red Bluff. Along with our local affiliated Dignity Health hospitals (Mercy Medical Center Mt. Shasta Mercy Medical Center Redding and St. Elizabeth Community Hospital) we offer an integrated care delivery system that provides high quality compassionate care in family medicine, internal medicine, OB/GYN, cardiology, neuro-interventional, general surgery, endovascular surgery, endocrinology, ENT, colorectal surgery, thoracic surgery and orthopedic surgery including general total joints and spine.

One Community. One Mission. One California

Total Rewards

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards.