Prior Authorization Specialist

Iowa Radiology P C; Clive (IA); Presencial; USD 22.000 - 30.000; A tiempo parcial

Descripción de la vacante

Iowa Radiology P C is seeking a part-time Prior Authorization Specialist to secure timely insurance authorizations and support patient access to care. The role requires working 24 hours per week, with Monday availability, in a collaborative office setting.

The ideal candidate will have 2+ years of prior authorization or insurance verification experience, familiarity with CPT/ICD-10 coding, and strong communication skills. Proficiency with RIS, Epic, payor portals, and Microsoft Teams is expected.

Formación

• Two or more years of medical prior authorization, referral, or insurance verification experience required.
• Knowledge of payor requirements, medical terminology, CPT/ICD-10 coding.
• Fundamental typing and filing skills.
• Must read/write/speak fluent English.

Responsabilidades

• Verify patient insurance coverage and obtain prior authorizations via portals, phone, and fax.
• Manage imaging orders and ensure authorizations before scheduled exams.
• Upload clinical documents to support requests and track them through approval.
• Handle denials, peer-to-peer reviews, and appeals with providers, patients, and insurers.

Conocimientos

Prior authorization

Insurance verification

CPT/ICD-10 knowledge

Typing skills

Fluent English

Communication skills

Attention to detail

Educación

High school diploma

Herramientas

RIS

Epic

Payor portals

Microsoft Teams

Multi-line phone system

Descripción del empleo

We are seeking a skilled and dedicated Prior Authorization Specialist to join our healthcare team. Iowa Radiology is a patient-centered practice that promotes a more compassionate approach to medicine. We provide our employees the ability to bring their authentic selves to work every day, providing compassionate care for our patients in a collaborative, supportive work environment.

We want YOU to join the Iowa Rad family!

We truly care about our employees, their health and well-being, and their career goals and aspirations. The ideal Prior Authorization Specialist will play a crucial role in helping us continue to be the premier provider of radiologic services in Iowa by securing timely insurance authorizations, supporting patient access to care, and ensuring accurate, complete documentation.

• Schedule: Part-time, 24 hours per week, weekday daytime hours. Must be available to work Mondays.

Responsibilities of the Prior Authorization Specialist:

Administrative

• Verify patient insurance coverage and obtain prior authorizations through payor portals, phone, and fax.
• Manage imaging orders and ensure authorizations are secured before scheduled exams.
• Upload clinical documents that support authorization requests and track each request until a decision is made.
• Handle denials, peer-to-peer reviews, and appeals in coordination with providers, patients, and insurers.
• Monitor Teams messages and respond to questions and inquiries from staff and referring offices in a timely and professional manner.
• Initiate good public relations and communicate effectively with patients, office personnel, and referring physicians' offices.
• Become proficient in RIS, Epic, and payor portals, as well as Microsoft Teams and the multi-line phone system.

Other Functions

• Attend staff meetings.
• Report problems related to staffing, morale, work methods, and procedures to the Supervisor.
• Functions other than those described above due to extenuating circumstances.

Qualifications of the Prior Authorization Specialist:

Education

• High school graduate or equivalent.

Knowledge, Skills, and Abilities

• Two or more years of medical prior authorization, referral, or insurance verification experience required.
• Knowledge of payor requirements, medical terminology, and CPT/ICD-10 coding.
• Must have a fundamental knowledge of typing and filing techniques.
• Must be able to read, write, and speak fluent English.
• Excellent verbal and written communication skills, with the ability to convey complex information to non-technical stakeholders.
• Strong organization and attention to detail.

Physical, Mental, and Visual Effort

• Continuous speaking, hearing, and visual effort.
• Must have the ability to communicate effectively and work independently.
• Continuous mental and visual concentration requiring attention-to-detail and accuracy.
• Working conditions are typical to a normal office environment.
• Must possess manual dexterity to operate computer and other office equipment.
• Ability to perform repetitive tasks associated with technology use (phone, computer, applications, and software).
• Must be able to bend, stoop, kneel, or crouch as part of job functions.
• Ability to lift and carry up to twenty-five (25) pounds when necessary.

Iowa Radiology, Professional Medical Management (PMM), and Iowa Diagnostic Imaging and Procedure Center (IDIPC), are equal opportunity employers. We are committed to fostering a diverse, inclusive, and respectful workplace. All qualified candidates are given equal employment opportunity without regard to race, color, national origin, sex, gender identity, sexual orientation, age, disability, religion, or any other characteristic protected by federal, state, or local law.

We celebrate diversity and are committed to creating an inclusive environment for all employees. Reasonable accommodations are available to individuals with disabilities from the application process and throughout employment with any of our companies.