Patient Account Representative – Diagnostic Scheduling Authorizations
Core
Obtains payer authorizations for scheduled diagnostic services, verifies requirements, submits requests, and follows cases through determination to prevent denials.
Role type
Patient Account Representative (Diagnostic Scheduling)
Builds
Diagnostic service authorizations for payers
Domain
Healthcare revenue cycle / Insurance verification
Required skills
Insurance eligibility verification, prior authorization processing, payer portal navigation, electronic health records (EHR) usage, Medicaid/Medicare/VA/commercial payer guidelines, written documentation, time management
Preferred skills
Epic/Meditech EHR experience, medical necessity knowledge, insurance A/R follow-up experience
Responsibilities
Obtain payer authorizations for diagnostic services, verify authorization requirements, submit complete authorization requests, follow pending cases through determination, communicate issues that could delay service or create denials
Seniority
Entry to Mid-level, individual contributor