Performance Profile

Clinical Review Nurse
Requisition Number: 4497 Division: East
Location: Wexford, PA
Classification: Full Time

Position Performance Profile:

Our culture:

At InSight Health Corp., there is a clear focus on people. We are committed to the selection, development and recognition of talent. We require leaders and employees who are creative, adaptive and who focus on excellence in patient care. Already known for the highest levels of service and technology, InSight employees add the human touch, caring for our patients and their families in a dignified and ethical way.
Our culture encourages a balance of teamwork and individuality, a big company with a small company entrepreneurial mind-set and customer friendly feel. At InSight, we live our InSight PRIDE values:

PRIDE values:

 

P

atients First

Do the 

R

ight Thing

Encourage 

I

nnovation

 

D

eliver on Commitments

 

E

njoy What We Do

Job Description
INSIGHT IMAGING is a leading provider of radiology services, with more than 150 fixed imaging facilities and mobile units located in over 30 states. We offer a full continuum of diagnostic imaging services that complement existing community healthcare resources and focus on the specific needs of each distinct medical community. The culture is informal, has a strong field presence and encourages a balance of teamwork, individuality and a strong focus on patient care. The pay is competitive, the benefits excellent and the work meaningful and rewarding.

We are seeking a Clinical Review Nurse. Under close supervision, perform a variety of nursing/clinical and customer service support tasks such as answering telephone calls, screening & assessing patients for PET scans, scheduling patients, and collect / coordinate medical necessary documents. Monitor and maintain Schedule Records and perform other related duties as required.

Examples of Essential Functions:
  • Handle telephone calls in a concise manner, utilizing clear verbal communication skills with physicians’ and other parties calling the scheduling center.
  • Greet patients in a professional and friendly manner, and assist patients with registration materials as required.
  • Screen and assess patients prior to procedure for any precautions or contra-indications
  • Prioritize the dissemination of scheduling information according to physician order, hospital site, and timeliness
  • Review Scheduling Records and interpret information critical for PET scanning and physician diagnosis.
  • Appropriately contacts patient to review a baseline assessment, explain PET procedures, provide patient education, and functions as a patient liaison.
  • Follow company collection policy by informing patients of their financial obligations and collecting payment at time of service.
  • Monitor and maintain schedule records accurately. Forward all necessary documents in an accurate and timely manner.
  • Obtain all necessary patient information and demographics that pertain to the current exam including previous x-rays, charts and medical records.
  • Assist in cross-training scheduling personnel to become proficient in ancillary areas as requested by supervisor.
  • Verify insurance eligibility and obtain prior authorization (if required) by contractual or non-contractual agencies or insurance carriers.
  • Compose and type correspondence, memorandums, reports and tables using word processing and spreadsheet applications (where applicable).
  • Perform preventive maintenance on all front office and secretarial related equipment and report all problems or breakdowns immediately to the supervisor.
  • Comply with all applicable laws, rules and regulations, the company’s policies and procedures, and The InSight Integrity Program.
  • Perform other projects/tasks, as requested by the Company.

    The ideal candidate has:
  • High school graduate or equivalent.
  • LPN / RN License

    Desirable:
  • Working knowledge of clinical indications / insurance criteria for PET scans.
  • Working knowledge of Diabetic Management.
  • CPR Certification.

    Knowledge:
  • Working knowledge of cancer diagnoses & treatments.
  • Medical terminology.
  • Knowledge of Multi-line phone system
  • Basic typing and computer knowledge.
  • Customer service principles and techniques.
  • Office filing and record keeping techniques.
  • Read and interpret printed insurance plan coverage.

    Skills & Abilties:
  • PC skills, software such as: Office Word, Excel, Outlook.
  • Handle telephone calls using proper telephone etiquette.
  • Operate standard office equipment such as PC base software, copiers and facsimile equipment.
  • Schedule, organize and complete work in accordance with deadlines and time constraints.
  • Verify, copy, fax and distribute documents and messages.
  • Communicate effectively with staff, management, clients, healthcare representatives, and all external customers.
  • Maintain confidentiality of patient records.


    		•
    Required Skills
    Special Requirements/Certification:
  • Current LPN / RN License
  • OSHA Class II risk of exposure to Bloodborne Pathogens.

    To ensure that we continue to hire competent, ethical and trustworthy individuals, all candidates must successfully complete a thorough background investigation prior to beginning employment with INSIGHT IMAGING.
    		•
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