Referral Coordinator / Prior Authorization Specialist

Referral Coordinator / Prior Authorization Specialist

Responsible for scheduling IR procedures, and support the physicians, nurses, and patients of the IR department.

Summary: Responsible for scheduling IR procedures, and support the physicians, nurses, and patients of the IR department.

Essential Functions:

  • Schedule patients for IR procedures
  • Contact patients, Doctor’s office, insurance company, Third Party Administrator demographics, in order to have complete, accurate, compliant patient records.
  • Ensure a written order is received with specific information.
  • Verify insurance coverage, as well as obtain a pre-cert number for the procedure.
  • Obtain updated patient health history, demographics, known allergies, medications, and conditions.
  • Confirm the appointment one day prior to procedure to keep the schedule running smoothly.
  • Act as liaison between referring doctor’s office and patient by handling all questions or concerns prior to the procedure to maximize the physicians’ time to be maximized for procedures.
  • Handle all necessary paperwork for same day add-ons.
  • Ensure that areas/resources of hospital are available at time of service, without conflicts.
  • Coordinate with referring physician’s office or patient to ensure they are instructed to stop appropriate medications and ensure clearance is obtained.
  • Ensure patient has received specific prep instructions, along with time of procedure, what to expect the day of the procedure, and where to check in.
  • Obtain for prior imaging, from outside facilities, to be available prior to scheduling the procedure.
  • Arrange admission to the hospital and enter information into the hospital information system as needed.
  • Reschedule or follow-up with patients as directed.
  • Obtain procedural reports and update the patient’s medical record.
  • Request films and charts from Medical Records as directed.
  • Send lab reports to referring physician.
  • Comply with hospital regulations regarding patients and scheduling.
  • Communicate with physicians and nurses to keep updated of necessary changes.
  • Interpret plan provider requirements for pre-certification procedures.
  • Regular and timely attendance required.
  • Serve as resource person to the Business Office for help with coding questions
  • Assist with maintaining the charge coding sheet.
  • Monitor storage of medical records related to this area of the practice
  • Provide high level of customer service to patients, physicians/PA’s/NP’s/nurses, referring physicians’ offices, hospital staff, RANT co-workers and all external service providers.
  • Define problems, collect data, establish facts, draw valid conclusions
  • Ability to resolve scheduling conflicts, and patient’s concerns
  • Support group, department and company goals
  • Make recommendations and implements processes to improve work flow.
  • Attend and actively participate in meetings as needed.
  • Ensure efficiency and accuracy of data.
  • Maintain excellent communication between physicians and nurses.
  • Support department and company goals
  • Make recommendation and/or suggestions to improve procedures.
  • Assist department as needed on special projects.
  • Ensure equipment is in good working order.

Qualifications:

Education: High school graduate or GED; CPT and ICD-10 certification preferred.

Experience: One to three years related medical office or clinical assistant experience in a high volume environment, or equivalent combination of education and medical office experience.

Skills/Knowledge: Mathematical skills, good verbal and written communication skills. Must be detail oriented, and able to work in a fast-paced environment. Able to manage multiple priorities and personalities. Function as a team player.

We value our local community and are committed to providing opportunities.

Radiology Associates of North Texas (RANT) is the largest, 100% radiologist-owned and operated practices in the US and has served Texas since 1937. Our 260+ radiologists and 30+ APPs provide professional coverage for over 65 hospitals, 47 imaging centers, and more than 100 other imaging entities throughout Texas. Our robust business office is growing and thriving.

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