Lead, Imaging & Prior Authorization

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Time Type:

Full time

Department:

Referrals

All Locations:

151 Orleans Street

Position Summary:

Imaging and Prior Authorization Team Leader is a critical position within the Referral Department that provides performance coaching and training of new staff; as well as being the content expert for Imaging processes including outside facility workflows and Prior Authorizations. They will assist in troubleshooting issues and providing support before including management. They serve as a role model and use good judgement in problem solving. The Team Leader also supports Management by monitoring Referral processing and completion of daily administrative tasks when management is in meetings and/ or unavailable. This position also supports in overseeing the day-to-day workflows of the staff by making adjustments to staff assignments, and completing specific tasks such as in basket messages. In addition, (s) he makes recommendations for improvements within the department. This step on the Referral Department career ladder is generally achieved through internal promotion. Professional staff in this position demonstrates strong leadership, superior customer service, written and verbal communication, judgment and problem solving skills.

Essential Duties & Responsibilities              

• Assist in the coordination of and the direct administration of training new staff as well as any updated training of existing staff in their respective team: Direct scheduling in BMC, uploading In physician gateway, obtaining prior auths

• Make recommendations for improvement with the Referral Department specifically in their respective teams as well as participating in Continuous Improvement Projects.

• Provides management with input for staff evaluations and performance concerns.

• Identifies all clinical needed to obtain prior authorization and avoid peer to peer.

• Responsible for sorting incoming electronic faxes and authorization requests from outside facilities.

• Responsible for covering phones whenever staffing is short to ensure internal providers can always get through for assistance.

• Responsible for working with management to ensure if staff are out  work queues have a backup covering urgents

• Assist with providing coaching on errors when supervisor unavailable

• Monitor imaging work queues and communicate to management any issues or backlog noted.

• Communicate with ordering providers and patients in a timely manner to ensure referrals are processed are efficiently and accurately

• Handle provider calls for assistance with entering referral orders

• Assist management with granting access to and troubleshooting insurance portals for Prior Authorizations

• Manage In-basket messages for authorizations and insurance issues

• Work cooperatively and respectfully with other departments and staff at all levels of the organization

• Handle Radiologist calls for up coding

• Attend Insurance Seminars/webinars for Prior Authorizations

• Promotes a sense of “team work” and contributes to the overall success of the department and assigned Practice(s) by assisting colleagues whenever possible.

• Take initiative to perform a wide variety of activities contributing to the smooth functioning of the department.

• Demonstrates self-direction, self-motivation, and independence.  Exercises excellent judgment, in knowing when and how to involve your supervisor; utilize all available resources before seeking assistance.

• Communicating with management to update tasks or assignments as needed to ensure work queues are coverage including lunches.

      

EDUCATION:

• High School Diploma or G.E.D. required
• Bilingual skills preferred  

EXPERIENCE:

• At least two years of experience working in health care and/or referral department with a focus on creating an excellent patient experience.

SKILLS/ABILITIES:

• Demonstrate excellent communication skills and ability to interact professionally with individuals at all levels.
• Display exemplary leadership skills; ability to troubleshoot and problem solve issues effecting operations
• Proficiency with technology using Windows, Epic, Workday, Touch Point & Oracle systems
• Demonstrate flexibility while being able to multi task and in a fast-paced environment.

EEO & Accommodation Statement:

NeighborHealth is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to [email protected] or call 617-568-4480 to let us know the nature of your request

Federal Trade Commission Statement:
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website. We do not ask or require downloads of any applications, or “apps.” Job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

E-Verify Program Participation Statement:

NeighborHealth participates in the Electronic Employment Verification Program, E-Verify. As an E-Verify employer, all prospective employees must complete a background check before beginning employment.