Job Description

Precertification Radiology Liaison - Mount Kisco, NY at Optum summary:

The Precertification Radiology Liaison coordinates and verifies authorizations for advanced imaging studies, ensuring timely approvals and clear communication with patients and providers. This role involves managing authorization data, addressing authorization-related inquiries, and collaborating with radiology and precertification teams to support patient care. The position requires healthcare knowledge, customer service experience, and proficiency with medical coding and administrative systems.

Optum New York, (formerly Optum Tri-State NY) is seeking a Precertification Radiology Liaison to join our team in Mount Kisco, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.

At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Precertification Radiology Liaison is responsible for working closely with both the Precertification/Authorization department and Radiology Clerical team to confirm and coordinate approvals for all advanced imaging studies.

This position is full-time, Monday – Friday. Employees are required to work any of our 9-hour shift schedules during our normal business hours of 8:00am – 6:00pm with a 1-hour lunch. It may be necessary, given the business need, to work occasional overtime. Employees are required to work 2 days onsite and 3 days from home.

We offer 6 weeks of paid training. The hours during training will be 8:00am – 6:00pm, Monday – Friday. Training will be conducted onsite.

If you are within commutable distance to the office at 100 S Bedford Road, Mount Kisco, NY, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Review all Radiology advanced imaging schedules for all locations minimum 2-3 days prior.
• Follow up on all missing/pending exams and compile a list to send to the authorization team.
• Review authorizations for validity including expiration date.
• Update the missing/outstanding lists for all sites.
• Obtain all authorization information for exams ordered by outside providers & add/update authorization information appropriately once obtained.
• Communicate clearly with patients to update them on the status of their authorization.
• Answer patient authorization inquiries.
• Manage all upgrade/downgrade requests sent by Radiology technologists.
• Work with appropriate staff to obtain authorizations for sessional providers.
• Obtain contracted rates for patients when necessary.
• Provide Radiology team with exam cost and ABN’s for self-pay patients.
• Manage each site’s stat radiology requests.
• Forward stat notifications to designated precert rep.
• Work to fill gaps in radiology schedules when appointments are cancelled due to pending or denied authorizations.
• Facilitate solutions to problems/issues.
• Process diagnoses changes.
• Perform other various related duties as necessary to assist in patient care.
• Assist with special projects & tasks.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED
• Must be 18 years of age OR Older
• 6+ months of experience with prior authorizations
• 2+ years of experience in Customer Service
• Experience with Microsoft Word, Excel (create, edit, save documents and spreadsheets) and Outlook (email and calendar management)
• Knowledge of ICD-9 and CPT codes
• Ability to work any of our 9-hour shift schedules during our normal business hours of 8:00am – 6:00pm with a 1-hour lunch. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Experience working within the health care Industry and with health care insurance
• Experience working in a hospital, physician's office or medical clinic setting
• A clerical or administrative support background
• Experience working in a call center

Telecommuting Requirements:

• Reside within commutable distance to the office at 100 S Bedford Road, Mount Kisco, NY
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

• Ability to follow oral and written instructions
• Ability to maintain, organize and respond to high volume email communication
• Ability to effectively communicate with patients, physicians, and employees within the organization
• Ability to adequately use, or learn to use, the department's computerized system and its associated devices
• Experience working within the health care Industry and with health care insurance

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #RED #RPOLinkedIn

Keywords:

precertification, radiology authorization, advanced imaging, patient communication, healthcare insurance, medical coding, ICD-9, CPT codes, customer service, healthcare administration

Job Tags

Hourly pay, Minimum wage, Full time, Work experience placement, Local area, Remote job, Home office, Shift work, Monday to Friday,

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