Radiology Prior Authorization Specialist (Vapi)

Taglynk; Vapi; On-site; INR 350,000 - 650,000; Full time

Job summary

Taglynk is seeking a meticulous Radiology Prior Authorization Specialist to manage the full PA lifecycle for imaging procedures (MRI, CT, Ultrasound). You will collaborate with radiologists, technologists, billing staff, and insurers to secure timely approvals and maintain compliant documentation.

The role requires at least 3 years of prior authorization experience, preferably in radiology, with strong knowledge of medical necessity criteria, payer guidelines, and HIPAA.

Qualifications

• 3+ years of medical prior authorizations, preferably radiology.
• Experience in radiology centers is highly desirable.
• Knowledge of medical necessity criteria and pre-certification processes.

Responsibilities

• Manage full PA lifecycle for radiology procedures.
• Assess submissions for medical necessity and payer guidelines.
• Coordinate with radiologists, imaging, and billing teams.
• Communicate with insurers to resolve denials and appeals.
• Maintain compliant PA records and correspondence.
• Identify and fix bottlenecks to speed turnaround times.
• Track payer policy updates and imaging tech changes.
• Suggest workflow improvements for the radiology PA process.
• Leverage EMR/RIS and PA platforms for submissions.
• Ensure HIPAA compliance across all activities.

Skills

EMR/RIS proficiency

Payer portals

Attention to detail

Communication skills

Independent & collaborative

Education

Medical Coding Certification

Healthcare Administration Certification

Tools

RIS platforms

EMR systems

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 new 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: Solid 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.