Insurance Authorization Specialist
Job Summary:
We are seeking an experienced and detail-oriented Insurance Authorization Specialist to join our busy imaging facility. This role is essential in ensuring timely and accurate insurance authorizations for radiology procedures, including MRI, CT, and X-ray. The ideal candidate is fast-paced, adaptable, and thrives in a multi-tasking environment. Excellent communication and customer service skills are essential.
Key Responsibilities:
- Obtain prior authorizations for imaging procedures from insurance companies, including MRI, CT and X-ray.
- Verify patient insurance eligibility, benefits, and requirements for imaging studies.
- Communicate directly with insurance representatives, referring physician offices, and patients to gather necessary information.
- Ensure all authorization approvals are documented accurately in the EMR and scheduling systems prior to appointments.
- Monitor and follow up on pending authorizations to prevent delays or rescheduling.
- Appeal denied authorizations and work collaboratively with radiologists and referring providers to obtain supporting clinical documentation.
- Maintain current knowledge of insurance payer guidelines and radiology authorization protocols.
- Deliver excellent customer service when assisting patients with insurance-related questions or concerns.
- Coordinate with front desk, scheduling, and billing teams to support efficient patient flow and minimize disruptions.
Qualifications:
- Required: Minimum 1–2 years of prior experience in insurance authorization in a radiology or imaging setting.
- Strong understanding of radiology procedures and insurance requirements, including commercial, Medicare, and Medicaid plans.
- Ability to work efficiently in a fast-paced, high-volume environment while maintaining accuracy and professionalism.
- Excellent communication and interpersonal skills with a strong patient-service orientation.
- Highly organized with the ability to prioritize and handle multiple tasks.
- Comfortable learning and using EMR and scheduling software systems.
- Preferred but not required: Bilingual in English and Spanish (or another language).
What We Offer:
- Supportive and team-oriented work environment
- Opportunities for professional development in the healthcare field
- Comprehensive benefits package, including 401K.
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