Welcome to Beverly Hospital, part of Beth Israel Lahey Health. Beverly Hospital is a full service, community hospital providing leading-edge, patient-centered care to North Shore and Cape Ann residents. The hospital provides a full-range of state-of-the-art care and services including primary care, cardiovascular care, surgery, orthopedics, emergency care, maternity, pediatrics, as well as many other specialties. Beverly Hospital is nationally recognized for patient safety as it is one of only 42 hospitals in the United States to be awarded an “A” grade from The Leapfrog Group – the nation’s leading nonprofit watchdog on hospital quality and safety.
Beverly Hospital promotes the culture and philosophy which enables employees to give and receive the best of care. You can become a part of the team that achieves this success through our CREATE values of Community, Respect, Excellence, Accountability, Teamwork and Empathy.
About the Job
The MRI Authorization/Scheduling Coordinator’s primary responsibility is to obtain outpatient preauthorization’s for all MRI orders prior to scheduling under the direction of the MRI Scheduling Supervisor/Client Services Facilitator.
- Performs the function of obtaining MRI authorizations prior to scheduling from the insurance company and/or their third party vendors including NIA, AIM, Medsolutions and Evicore.
- Fax preauthorization request and follow-up on all preauthorization approvals and denials that are required by the referring provider’s office to process.
- Reviews all MRI outpatient electronic orders for preauthorization determination.
- Maintains awareness of different sources available to inquire or request authorizations including verification of insurance eligibility and benefits.
- Documents the referral record in detail with the authorization number, CPT code, ICD10 code, insurance information, location and effective date of authorization.
- Notifies referring provider if authorization is denied, pending for additional clinical information or requires a peer to peer review.
- Works with the referring provider offices to appeal an authorization by obtaining clinical documentation which is uploaded to the insurance/third party vendors’ portal for clinical review.
- Contacts the referring provider and/or the patient to notify of a peer to peer.
- Follow-up within 24 to 48 hours for decision on all clinical uploads for a peer to peer.
- Notifies the referring provider/patient if the request is denied.
- Participates in training new staff.
- Assumes responsibility for all communications for MRI scheduling.
- Calls outpatients to schedule from the Front Desk Orders Report/Schedule Orders Work Queue that have been preauthorized.
- Obtains demographic and health insurance information from patient and/or referring physician’s office. Coordinates the scheduling of all specialized scans and patient populations, i.e. inpatients, arthrograms, sedated patients, and pediatric cases.
- Coordinates courteous interactions between the MRI Dept. and physician offices. Contacts taxi service, ambulance and interpreter service when necessary.
- Maintains a “READY” state in ACD phone system and answers ACD calls promptly.
- Updates computer files when patients do not keep their appointments or are not able to be scanned (i.e. claustrophobic.
- Corrects any problems or unfinished business from the previous shift.
- Expedites the processing of patient accounts in coordination with the Coding/Pre-Registration staff by completing a full EPIC Registration on all patients that are scheduled.
- Processes “no show” and “same day reschedule” patients daily.
- Backup support when needed to validating patient paperwork, processing incoming faxes, and transcribing/scanning outside orders into EPIC.
- Confirm patients for scheduled MRI’s and/or patient with special instructions.
- Adheres to the protocol guideline booklet, calls radiologist for approval when contrast needs to be changed.
- Advises the technologist/radiologist of any patient request and/or referring provider’s preference/requests.
- Assists with training of new employees.
- Reads and responds to all e-mails appropriately and in a timely manner.
- Completes special projects as requested by management.
40 hours per week, day shift.
Beth Israel Lahey Health is an integrated system providing patients with better care wherever they are. Care informed by world-class research and education. We are doctors and nurses, technicians and social workers, innovators and educators, and so many others. All with a shared vision for what healthcare can and should be. We are committed to attracting, developing and retaining top talent. We strive to create a diverse and inclusive workplace that reflects the communities in which we work and serve. With a team approach to care, we encourage learning and growth at all levels and offer competitive salaries and benefits.
Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.
High school graduate required. Advance education preferred.
Knowledge of PC computer systems, ability to learn basic scheduling software and work with word processing applications.
Licensure, Certification & Registration:
4-5 years’ experience in a fast-paced health care medical facility setting preferably in registration and authorizations.
Skills, Knowledge & Abilities:
Typing speed 50 WPM, third party payor knowledge and insurance background required.
Must have excellent communication and organizational skills.
Must maintain a professional manner and appearance.
Must be able to work independently as well as in a team.