PreArrival Associate - IM Radiology - FT Days (62725)

Responsible for facilitating patient access for services at Maryville Imaging, LLC by accurately and efficiently verifying patient insurance eligibility and obtaining any appropriate pre-certifications or medical necessity prior to the patient receiving scheduled or non-scheduled services and then completing the pre-registration for the patient visit. This position is responsible for communicating to the Financial Clearance Associate any patients that will be presenting without insurance for further assistance.

This position is responsible for providing excellent customer service when communicating with patients while also protecting the privacy of the patient’s health information. This position will also perform as backup to the Financial Clearance Associate as needed. Primary

Obtains patient personal information and pertinent insurance information to accurately verify insurance eligibility, pre-certification information, financial obligations and medical necessity prior to creating the patient pre-registration. Utilizes appropriate strategies, including phone calls and online databases to verify the insurance coverage of scheduled patients. Obtains benefit information such as deductible, co-payment and co-insurance amounts.

Collaborates with the physician offices to obtain any pre-certification information prior to the day of service and documents this information in patient record in the registration system. This includes obtaining additional an additional diagnosis when a test does not pass medical necessity. Communicates with the Financial Clearance Associate any financial obligations due that need to be communicated to the patient prior to the day of service and any patients that do not have insurance and require financial counseling so that the patient is advised prior to the day of service what their financial obligations will be at the time of service.

Communicates with the physician offices when the patient does not present with a valid order and identifies to the physician office what is needed to be re-sent to the imagining center so that the patient can receive the services. Identifies when a physician is not in the registration physician dictionary and forwards that physician information to HIM to be added accordingly. Coordinates the pre-registrations for the day of service for the patient access staff.

Assists the Patient Access staff with add-on or walk-in patients, determining if testing needs pre-certification and making phone calls to verify coverage. Counsels walk in patients when needed regarding financial assistance. Performs quality improvements to records as indicated by the quality improvement tool (RQi) in a timely and efficient manner.

Performs other miscellaneous assignments and/or duties as related to the position. Other miscellaneous assignments and/or duties as related to this position: Assists and performs as backup to the Financial Clearance Associate functions and responsibilities i.e. determining patient insurance eligibility, reviewing medical necessity, obtaining insurance pre-certifications from physician offices and/or creating pre-registrations as needed.