Job Description

JOB SUMMARY: Responsible to obtain Prior Authorizations for MRI. Liaison for Patients, Clinical staff, Insurance carriers to facilitate authorizations for patient MRI procedures.

EDUCATIONAL REQUIREMENTS:

• High school diploma required
• Certified Professional Coding designation helpful
• Medical terminology

QUALIFICATIONS AND EXPERIENCE:

• Minimum 1-year experience working in a physician group practice
• Knowledgeable of Anatomy & Physiology, and medical terminology
• Current working knowledge in CPT and ICD-10 codes
• Knowledge of Medicare/Medicaid, Workers Compensation and Commercial Insurance carrier clinical policies and reimbursement guidelines
• Ability to perform multiple tasks simultaneously
• Strong written and verbal communication skills
• Neat, professional appearance

Responsibilities include, but are not limited to, the following:

• Verify medical necessity guidelines for each carrier, based on Provider notes and CPT/ICD-10 codes for MRI procedures.
• Complete Prior Authorization process for MRI procedures in a timely manner.
• Document authorization and all pertinent information in the patient chart.

Other:

• Maintain patient confidentiality; Comply with HIPAA and compliance guidelines established by the practice.
• Maintain detailed knowledge of practice management, and other computer software, as it relates to job functions.
• Attend regular staff meetings and continuing education sessions, as requested.

Typical Physical Demands:

Work may require sitting for long periods of time, and also stooping, bending and stretching for files and supplies. Employee will occasionally be asked to lift files or paper weighing up to 30 pounds. Position requires manual dexterity sufficient to operate a keyboard, operate a computer, telephone, copier, and such other office equipment as necessary. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. Position also requires viewing computer screens and typing for long periods of time.

OSG offers a pleasant professional work environment, competitive wages, and comprehensive benefits, including generous paid time off.

Orthopaedic Specialty Group, P.C., is an Equal Opportunity Employer

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