MRI and CT Prior Authorization Specialist
11 hours ago
*** Looking for IMMEDIATE JOINER ***
Job Description:
We are seeking a dedicated MRI and CT Prior Authorization Specialist to join our Radiology Services team. This role is critical in ensuring prior authorizations for MRI and CT scans are obtained efficiently while maintaining close communication with physicians to secure scripts, medical records, and necessary documentation. The ideal candidate will be detail-oriented, communicative, and experienced in the U.S. healthcare and insurance systems.
Key Responsibilities:
- Obtain prior authorizations for MRI and CT imaging procedures from insurance providers.
- Contact physicians and healthcare providers to request scripts, medical records, and supporting documentation for authorization submissions.
- Submit accurate and timely prior authorization requests, following payer-specific guidelines.
- Follow up with insurance companies to resolve denials, appeals, or additional information requests.
- Collaborate with radiology teams and billing departments to ensure proper coding (e.g., CPT/ICD-10).
- Maintain detailed records of authorization statuses in electronic health record (EHR) systems.
- Keep physicians and staff informed of authorization progress and requirements.
- Stay current on insurance policies, radiology procedures, and compliance standards (e.g., HIPAA).
- Provide exceptional support to patients regarding authorization inquiries.
Qualifications:
- High school diploma or equivalent required; degree in healthcare administration or related field preferred.
- Minimum of 2 years of experience in prior authorization or radiology services.
- Strong understanding of MRI and CT procedures and medical terminology.
- Proven ability to communicate effectively with physicians and insurance representatives.
- Familiarity with U.S. insurance processes (e.g., Medicare, Medicaid, private insurers).
- Proficiency in EHR/EMR systems and Microsoft Office Suite.
- Excellent organizational skills and the ability to manage multiple priorities.
Preferred Skills:
- Certification in medical billing/coding (e.g., CPC, CPB) is a plus.
- Experience with radiology-specific software (e.g., RIS, PACS) is advantageous.
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