Clinical Specialist- Remote Opportunity

Welcome to Akumin! As a leading provider of radiology and oncology services in the United States, we are dedicated to improving the diagnosis and treatment of patients through the use of advanced technology and expert clinical and operational knowledge. Our network of owned and operated imaging locations offers a range of outpatient diagnostic procedures, including MRI, CT, PET, and more. In addition, we provide a full suite of diagnostic imaging and cancer care services, including radiation therapy, to over 1,000 hospitals and health systems across 48 states. Our goal is to make healthcare more efficient and effective for both patients and providers. Thank you for considering a career with us!
Benefits Offered Depending on Eligibility:

• Employee Assistant Program
• Retirement Plan and Company Match
• Paid Time Off: Vacation, Sick, & Holiday
• Company Paid Life Insurance, AD&D and Disability
• Medical, Prescription, Dental & Vision
• Savings and Spending Accounts: HSA & FSA
• Supplemental Life Insurance and AD&D
• Additional Voluntary Benefits!

Remote opportunity for experianced medical coder CPT codes and ICD 9 codes
The Clinical Specialist I reviews patient accounts prior to a scan and compares supporting clinical documentation to insurers’ and/or government programs’ published medical policies. Based on the available information, assesses the likelihood that the scan will meet the payers requirements for coverage. When necessary, requests additional medical information from physicians’ office to support the utilization review process, recommend that a waiver is signed or to recommend that other financial arrangements are made if the scan does not meet medical necessity.
Specific duties include, but are not limited to:

• Completes any additional job duties as assigned.
• Ability to read medical history and identify medical necessity according to provider’s policy.
• Knowledge of medical terminology and knowledge of the reading and interpreting of radiology reports.
• Completes all necessary paperwork for government program participation according to strict program guidelines. Established and monitors escrow accounts for administrative fees.
• Team member must be familiar with medical polices, and how they relate to scans ordered.
• Communicates with physician’s offices, explains the need for additional medical information to support the Utilization Review process as needed.
• Excellent customer service skills, knowledge of insurance providers and plans.
• Knowledge of multi-modalities imaging reports.
• Must have prior knowledge of basic coding; be familiar with CPT codes and ICD 9 codes.
• Conducts review process on scans ordered. Compares compliant RXs, clinical and history information provided by referring physicians to payers’ medical policies to assess likelihood of meeting medical necessity requirements. Studies all supporting documentation including the review of ICD 9 and CPT codes.
• 1-2 years of experience in medical or related field required.
• Communicates with offices, patients and the Schedule Coordinator II to inform them that the scan does not appear to meet medical necessity for the payer and recommend that an Advance Beneficiary Notice (ABN) non-covered waiver, other Commercial waiver or other financial arrangements be made prior to the scan.
• Prioritizes tasks according to scan dates. Requests missing initial clinical information or a compliant order from the Schedule Coordinator II. Notifies the Schedule Coordinator II when scans do not appear to meet payer coverage requirements.
• Must be knowledgeable and comfortable communicating with doctors and their office staff, and educating them in UR and MN.
• High School Diploma or equivalent experience required.

Akumin Operating Corp. and its divisions are an equal opportunity employer and we believe in strength through diversity. All qualified applicants will receive consideration for employment without regard to, among other things, age, race, religion, color, national origin, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.