Radiology Prior Authorization Specialist (Mangalore)

Taglynk; Mangaluru; On-site; INR 500,000 - 750,000; Full time

Job summary

Taglynk seeks a meticulous Radiology Prior Authorization Specialist to oversee the PA process for radiology procedures, ensuring timely approvals and compliance. You will collaborate with radiologists, technologists, billing staff, and insurers to facilitate access to MRI, CT, and other imaging services and maintain complete records.

Drive workflow improvements, review submissions for medical necessity, and stay current with payer policies and radiology advances to accelerate approvals and

Qualifications

• Minimum of 3 years handling medical prior authorizations, preferably in radiology or imaging services.
• Experience in a radiology center or with radiology teams is highly desirable.
• Familiarity with radiology procedures, medical necessity criteria, and pre-certification processes.
• Proficient with EMR/RIS platforms and payer portals.
• Strong written and verbal communication skills to coordinate across departments.

Responsibilities

• Manage the full lifecycle of prior authorizations for radiology procedures and imaging services (MRI, CT, PET, Ultrasound).
• Assess submissions for completeness, alignment with medical necessity and payer guidelines.
• Collaborate with radiologists, imaging departments, and billing teams to collect and submit documentation.
• Coordinate with insurance carriers to resolve denials, manage appeals, and minimize delays.
• Maintain detailed and compliant records of all authorizations and correspondence.
• Identify issues early and implement solutions to accelerate turnaround times.
• Stay current with payer policies and radiology technologies to ensure workflow compliance.
• Provide actionable insights to improve the radiology PA workflow; use EMRs and PA platforms.

Skills

Attention to detail

Communication skills

Independence

Team collaboration

Education

Medical Coding certification (preferred)

Healthcare Admin certification (preferred)

Tools

EMR/RIS

Payer portals

Job description

We are seeking a meticulous and proactive Radiology Prior Authorization Specialist to oversee and streamline the prior authorization (PA) process for radiology procedures. This role ensures timely and accurate approvals, reduces patient wait times, and supports compliance with payer requirements.

You will collaborate with radiologists, technologists, billing staff, and insurance providers to facilitate access to essential diagnostic and therapeutic radiology services.

Responsibilities

• Manage Prior Authorization Process: Handle the full lifecycle of prior authorizations for radiology procedures and imaging services (e.g., MRI, CT, PET, Ultrasound).
• Review Requests: Assess prior authorization submissions for completeness, ensuring alignment with medical necessity and payer guidelines.
• Team Collaboration: Work with radiologists, imaging departments, and billing teams to collect and submit accurate clinical documentation.
• Insurance Coordination: Communicate with insurance carriers to resolve denials,manage appeals, and minimize barriers to timely care.
• Maintain Records: Keep detail edand compliant records of all authorizations, including statuses and correspondence.
• Problem Resolution: Identify issues early in the process and implement solutions to accelerate authorization turnaround times.
• Stay Current: Monitor updates in payer policies and recent radiology technologies/procedures to ensure workflow compliance.
• Process Improvement: Provide actionable insights to improve the radiology PA workflow.
• Technology Utilization: Use EMRs (e.g., Radiology Information Systems) and PA platforms to manage submissions.
• Regulatory Compliance: Ensure all processes and documentation meet HIPAA and related standards.

Qualifications

• Experience: Minimum of 3 years handling medical prior authorizations, preferably in radiology or imaging services.
• Preferred Background: Experience in a radiology center or working with radiology teams is highly desirable.
• Technical Knowledge: Familiarity with radiology procedures, medical necessity criteria,and insurance pre-certification processes.
• Systems & Tools: Proficient with EMR/RIS platforms and payer portals.
• Communication: Strong written and verbal communication skills to coordinate across departments and with insurers.
• Attention to Detail: Ability to manage multiple requests and maintain accuracyunder time pressure.
• Independence & Collaboration: Capable of working autonomously while engaging effectively with clinical teams.
• Compliance: Deep understanding of HIPAA and regulatory frameworks.
• Certifications (Preferred): Medical Coding,Healthcare Admin, or similar qualifications. .