Imaging Pre-Authorization Specialist: MRI/CT Approvals

Tri-State Orthopaedics; Delaware (OH); On-site; USD 42,000 - 54,000; Full time

Job summary

Tri-State Orthopaedics & Sports Medicine is seeking a full-time Diagnostic Imaging Pre-Authorization Specialist to join our busy practice. You will review clinical notes, verify benefits, and submit prior authorizations for MRI/CT scans for all providers, ensuring timely care.

Responsibilities include proactive tracking, scheduling urgent authorizations, and clear communication with providers, imaging facilities, staff and patients while staying current with payer guidelines and HIPAA compliance.

Qualifications

• High school diploma or equivalent required; associate degree or medical certification is a plus.
• 1–2 years in medical billing, insurance verification, or prior authorizations.
• Knowledge of CPT and ICD-10 medical coding.
• Familiarity with radiology/advanced imaging terminology is a plus.
• Strong computer literacy and experience with EHR systems.

Responsibilities

• Review clinical notes for required content and verify benefits.
• Submit prior authorizations for MRI/CT and track statuses.
• Monitor imaging requests and relay information to payers as needed.
• Obtain and schedule STAT/URGENT imaging prior authorizations.
• Communicate authorization status with providers, facilities, staff and patients.
• Facilitate peer-to-peer reviews or appeals for denials with payers and providers.
• Stay current with payer guidelines and authorization requirements.
• Return calls and emails promptly; answer basic authorization questions.

Skills

Customer service

Telephone skills

Computer literacy

Medical terminology

Education

High school diploma or equivalent

Associate degree or medical certification (preferred)

Tools

EHR systems

Job description

Tri-State Orthopaedics & Sports Medicine is seeking a full-time Diagnostic Imaging Pre-Authorization Specialist to join our busy practice. You will review clinical notes, verify benefits, and submit prior authorizations for MRI/CT scans for all providers, ensuring timely care.

Responsibilities include proactive tracking, scheduling urgent authorizations, and clear communication with providers, imaging facilities, staff and patients while staying current with payer guidelines and HIPAA compliance.