Patient Insurance Navigator II

Overview:

Responsible for verification of patient eligibility, the pre-certification of services as required, ensuring coverages are updated, validating authorizations already on file, and providing price estimates upon request. Cross-training across all markets, injury coordinators, pre-scheduling authorizations, dedicated trainers, and quality assurance teams.

Responsibilities:

• Verify patient’s insurance status and benefit eligibility.
• Accurately determine the patient un-met deductible, co-insurance, and co-payment amounts
• Accurately and timely provide for any pre-authorization or pre-certification of services.
• Communicate with center staff, referring offices, team members, leaders, and schedulers.
• Provide high level of customer service with goal of maintaining low cancellation and auth denial rates while increasing Time of Service collection rates.
• Meet or exceed established productivity standards.
• Meet or exceed established quality assurance standards and maintain customer experience expectations.
• Meet or exceed established error standards.
• Meet or exceed expectations related to phone and instant message response time and quality of service provided in those interactions.
• Ensure patients that are not approved or covered for services are notified timely and provided all options including rescheduling and waivers.
• Provide price estimates prior to scheduling when requested.
• Proficient in at least one of the following areas: Cross-trained in all markets and work functions, Specialty workqueues such as injury coordinators, self-pay/No surprise billing, and pre-scheduling authorizations, Department training, Quality assurance
• Other duties as assigned.

Qualifications:

Education:

• High School Diploma or GED
• Associate’s degree in business administration or related field preferred

Prior Experience:

• 3 years’ experience

Special Qualifications:

• Ability to understand basic medical terminology.
• Knowledge of pre-certification process for insurance companies.
• Ability to calculate deductible and coinsurance correctly.

Company Message:

Diagnostic imaging supports other health care practices by using, MRI, CT, X-Ray, nuclear medicine and ultrasound technology to identify and diagnose a broad range of medical conditions. MedQuest provides full turnkey outpatient imaging center joint venture (JV) and management, including daily operations management, marketing, billing and collections, center development and all financial and other support functions.

MedQuest Associates offers competitive salaries and benefits packages. Please visit our website at www.mqimaging.com to learn more about our company.