Pre Certification Specialist

Pre Certification Specialist

Join MountainView Medical Imaging (A Radiology Partners practice): Make a local impact in the South Carolina area.

MountainView Medical Imaging is a proud affiliate of Radiology Partners (RP), one of the leading radiology practices in the US; at MountainView Medical Imaging, you'll work with some of the healthcare industry's most innovative minds on high-impact projects designed to move the practice of radiology forward.

At MountainView Medical Imaging, we believe transforming radiology starts with investing in the people who deliver care every day. As a practice of Radiology Partners (RP), MountainView Medical Imaging combines a strong local presence in Seneca, South Carolina with the support and resources of a leading national radiology organizationdelivering exceptional outpatient imaging while offering healthcare professionals meaningful, sustainable careers.

ABOUT MOUNTAINVIEW MEDICAL IMAGING & RADIOLOGY PARTNERS, INC.

At MountainView Medical Imaging, patients become friends through compassionate, state-of-the-art diagnostic imaging services delivered by board-certified subspecialized radiologists and skilled technologists. Committed to accuracy, convenience, and exceptional patient care, the team provides a welcoming environment, same-day appointments and reports, and reliable service at reasonable prices. MountainView also supports referring physicians with consistent, dependable quality benchmarks and a dedication to delivering the highest standard of diagnostic imaging care.

Together, RP and MountainView Medical Imaging we are redefining how imaging supports patients, referring providers, and the clinicians who make care possible. When you join MountainView Medical Imaging you'll be backed by Radiology Partners (RP)a nationally recognized organization that prioritizes clinical excellence and a people-first culture.

WHY JOIN US:

• Competitive compensation and comprehensive total rewards
• Opportunities for professional development
• True work-life balance in an outpatient setting: flexible scheduling with several shift options
• A fun, team-first culture at MountainView Medical Imaging collaborative, supportive, and grounded in safety and trust
• Community presence
• Leading the pack in the development of AI tools and technology resources

Radiology Partners has been Certified Great Place to Work for five consecutive years, reflecting the experiences of team members across our practices nationwide.

Position Summary:

• Receives prior authorization requests from the physician's office and completes referrals, clinical notes, demographics and enters this information into the radiology information system (RIS).
• Facilitates the receipt of the prior authorizations.
• Conducts appropriate follow-up, on a daily basis, on all pending authorizations until final determination has been made.
• Communicating authorization approval to the referring physician's office.
• Notifying the Scheduling Department if a scheduled exam is denied.
• Accurately documents all information and communications, verbal and written, with the patient, provider or insurance company, into the radiology information system (RIS).
• Answers all incoming calls from referring physicians, coworkers, and patients, in a pleasant and timely manner.
• Identifies prior authorization-related issues. Communicates appropriately to the PCC Supervisor regarding these and/or other departmental issues.

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE :

• High school diploma, or equivalent, and computer experience required.
• Knowledge of CPT and ICD-9 coding, authorization and eligibility practices and paperwork processing requirements
• Knowledge of medical terminology and eligibility software.
• Experience in using office equipment including telephone, fax, computer, adding machine and photocopier
• Ability to process authorization for an average of 30-35 exams per day, understand clinical notes, basic mathematical computations, pay close attention to detail for extended periods of time and communicate clearly in person and on the telephone.

COMPENSATION & TOTAL REWARDS

The hourly rate for this position is $18.00-20.00. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location etc. In addition to this range, Radiology Partners offers competitive total rewards packages, which include possible incentive and productivity programs, health & wellness coverage options, 401k benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements).

In addition to competitive pay, Radiology Partners offers a robust total rewards package, which may include:

• Health and wellness coverage options
• 401(k) with employer offerings
• Paid time off and paid holidays
• Incentive and productivity programs (where eligible)
• Family planning and telehealth benefits (All benefits subject to eligibility requirements.)

Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system overall. We hold that diversity is a key source of strength from which we will build a practice culture that is inclusive for all. Our goal is to empower and engage the voice of every teammate to promote awareness, compassion and a healthy respect for differences.

CCPA Notice: When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History.

Radiology Partners participates in E-verify. Beware of Fraudulent Messages: Radiology Partners will never request payment, banking or other financial information in exchange for interviews or as part of the hiring process. Additionally, we will not send checks for deposit into your bank account at any stage of recruitment. All communication during the interview and hiring process should come from an email address ending in " @radpartners.com." If you suspect you are receiving a fraudulent job offer or solicitation from Radiology Partners or one of our local practices, please email View email address on click.appcast.io to notify our team.