Imaging Pre-Authorization Specialist

Eastern Radiologists, Inc.; Greenville (NC); Sur place; USD 25 000 - 39 000; Plein temps

Résumé du poste

Eastern Radiologists, Inc. is seeking an Insurance Pre-Authorization specialist to verify insurance coverage, obtain prior authorizations, and validate medical necessity for diagnostic imaging and outpatient radiology services.

The role collaborates with insurers, referring providers, clinical staff, and scheduling teams to ensure authorizations are completed before services are rendered. You will help minimize denials, ensure accurate patient and payer information, and support compliant

Qualifications

• High school diploma or GED is required; an associate degree is preferred.
• Experience with insurance and CPT codes is desirable.
• Must be able to communicate clearly and maintain confidentiality.

Responsabilités

• Verify patients' insurance eligibility, active coverage, benefits, and plan requirements for radiology services.
• Verify prior authorizations for applicable imaging procedures and obtain authorization as needed.
• Review and validate authorization details against scheduled services.
• Confirm clinical documentation and diagnosis codes meet payer guidelines and medical necessity.
• Contact insurers to obtain authorization status and clarify requirements.
• Identify and address authorization issues to prevent claim denials.
• Coordinate with scheduling staff and providers to communicate authorization status and timelines.
• Document authorization numbers, dates, and related references in the EHR system.

Connaissances

Insurance verification

Prior authorization

Medical records review

Communication skills

Data entry accuracy

Formation

High school diploma or GED

Associate degree preferred

Description du poste

Eastern Radiologists, Inc. is seeking an Insurance Pre-Authorization specialist to verify insurance coverage, obtain prior authorizations, and validate medical necessity for diagnostic imaging and outpatient radiology services.

The role collaborates with insurers, referring providers, clinical staff, and scheduling teams to ensure authorizations are completed before services are rendered. You will help minimize denials, ensure accurate patient and payer information, and support compliant