Radiology Prior Authorization Specialist (Mount Abu)

Taglynk; Jaipur; On-site; INR 550,000 - 900,000; 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 diagnostic and radiology services.

The role requires 3+ years of prior authorizations in radiology or imaging, familiarity with EMR/RIS systems, and strong knowledge of payer guidelines.

Qualifications

• At least 3 years of medical prior authorizations experience, preferably in radiology or imaging services.
• Experience in a radiology center or working with radiology teams is highly desirable.
• Strong understanding of payer policies and HIPAA regulations.

Responsibilities

• Manage the full lifecycle of prior authorizations for radiology procedures and imaging services (MRI, CT, PET, Ultrasound).
• Assess prior authorization submissions for completeness and medical necessity.
• Collaborate with radiologists, imaging departments, and billing teams to collect and submit clinical documentation.
• Communicate with insurance carriers to resolve denials, manage appeals, and minimize barriers to timely care.
• Maintain detailed and compliant records of all authorizations and correspondence.
• Identify issues early and implement solutions to accelerate turnaround times.
• Monitor updates in payer policies and radiology technologies to ensure workflow compliance.
• Provide actionable insights to improve the radiology PA workflow.
• Use EMRs and PA platforms to manage submissions.
• Ensure HIPAA and related standards in processes and documentation.

Skills

Prior authorization experience

Radiology exposure

Healthcare billing

Tools

EMR systems

RIS

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 detailed and 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 K .