Prior Authorization Specialist - 100% Remote

Carol Milgard Breast Center; United States; Remote; USD 32,000 - 39,000; Full time

Benefits offered by this job

No nights, weekends, or on-call shifts

Medical, Dental, and Vision Insurance

HSA and FSA options

Employee Assistance Program (EAP)

Basic Life Insurance and Long-Term Dis

Holiday and PTO

Job summary

TRA Medical Imaging is seeking an experienced Prior Authorization Specialist for a fully remote role supporting radiology imaging services. You will ensure authorizations are in place, CPT/ICD-10 codes are correct, and medical necessity criteria are met across multiple imaging modalities.

The position requires at least 3 years of medical office insurance authorization experience, strong knowledge of radiology procedures, and excellent communication.

Qualifications

• High School Diploma or GED.
• Formal medical terminology training or equivalent medical office experience.
• Minimum 3 years of medical office insurance authorization experience.
• Knowledge of CPT and ICD-10 coding.
• Experience navigating insurance websites for eligibility and claim status.
• Understanding of radiology procedures and authorization workflows.

Responsibilities

• Obtain prior authorizations for imaging procedures including MRI, CT, PET, Nuclear Medicine, Fluoroscopy, Interventional Radiology, Mammography, Ultrasound, X-ray, and Bone Densitometry.
• Verify insurance eligibility, benefits, and authorization requirements.
• Ensure correct CPT and ICD-10 coding for all scheduled exams.
• Contact referring physician offices and insurance carriers to obtain required documentation.
• Review medical records to confirm medical necessity.
• Enter authorization numbers and detailed documentation into the RIS system.
• Educate patients on insurance and authorization requirements.
• Reschedule patients when authorization is pending.
• Provide price quotes and explain financial assistance options.
• Maintain HIPAA compliance and patient confidentiality.
• Collaborate with technologists, front desk staff, and scheduling teams to ensure exam accuracy.

Skills

Radiology procedures

Insurance verification

CPT coding

ICD-10 coding

Medical authorizations

Education

High School Diploma or GED

Formal medical terminology training

Tools

RIS systems

Job description

Prior Authorization Specialist (Remote – Select States Only)

TRA Medical Imaging

Remote | Full-Time | Monday–Friday | $23.27–$28.30 per hour

Applicants must reside in one of the following states to be considered: Alabama, Arizona, Georgia, Idaho, North Carolina, Texas, Utah, or Washington.

TRA Medical Imaging is seeking an experienced Prior Authorization Specialist with strong knowledge of radiology procedures, insurance verification, CPT coding, ICD-10 coding, and medical insurance authorizations.

This fully remote role supports our radiology practice by ensuring all scheduled imaging exams are authorized, medically necessary, and compliant with insurance carrier requirements. The ideal candidate has at least three years of medical office insurance authorization experience and thrives in a fast-paced healthcare environment.

Compensation and Benefits

Hourly Pay: $23.27 – $28.30 (based on experience, skills, and qualifications)

Benefits Include:

• No nights, weekends, or on-call shifts
• Medical, Dental, and Vision Insurance
• HSA and FSA options
• Employee Assistance Program (EAP)
• Basic Life Insurance and Long-Term Disability
• 401(k) with automatic 3% employer contribution plus up to 3% employer match
• 17 days of PTO
• 9 paid holidays
• Annual automatic compensation growth path
• Profit sharing
• Optional Pet Insurance, Legal, and ID Protection

About TRA Medical Imaging

TRA Medical Imaging is a physician-owned and physician-led radiology practice serving the South Puget Sound region for over 100 years. With approximately 100 subspecialized radiologists, TRA is committed to delivering high-quality, patient-centered imaging services while fostering a collaborative, high-trust culture rooted in Compassionate Care, Accountability and Integrity, Respect, and Excellent Service.

Position Overview

The Prior Authorization Specialist is responsible for ensuring all scheduled imaging examinations:

• Are authorized for the correct facility
• Include accurate CPT and ICD-10 codes
• Meet medical necessity guidelines
• Comply with insurance carrier and HIPAA requirements

This role works under established guidelines and immediate supervision within Health Information Management, Patient Access, and Scheduling functions

Key Responsibilities

• Obtain prior authorizations for imaging procedures including MRI, CT, PET, Nuclear Medicine, Fluoroscopy, Interventional Radiology, Mammography, Ultrasound, X-ray, and Bone Densitometry
• Verify insurance eligibility, benefits, and authorization requirements
• Ensure correct CPT and ICD-10 coding for all scheduled exams
• Contact referring physician offices and insurance carriers to obtain required documentation
• Review medical records to confirm medical necessity
• Enter authorization numbers and detailed documentation into the RIS system
• Educate patients on insurance and authorization requirements
• Reschedule patients when authorization is pending
• Provide price quotes and explain financial assistance options
• Maintain HIPAA compliance and patient confidentiality
• Collaborate with technologists, front desk staff, and scheduling teams to ensure exam accuracy

Required Qualifications

• High School Diploma or GED
• Formal medical terminology training or equivalent medical office experience
• Minimum 3 years of medical office insurance authorization experience
• Knowledge of CPT and ICD-10 coding
• Experience navigating insurance websites for eligibility and claim status
• Understanding of radiology procedures and authorization workflows
• Strong attention to detail and ability to manage multiple tasks
• Effective written and verbal communication skills
• Professional customer service skills

Preferred Qualifications

• Clinical experience in a radiology or imaging setting
• Experience working with RIS systems
• Experience with PET scan authorization processes
• Knowledge of HCPCS coding

Work Environment and Schedule

• Fully remote position (training and equipment provided)
• Monday through Friday, 9:00 AM – 5:30 PM Pacific Time

Ideal Candidate Profile

The ideal candidate is detail-oriented, experienced in radiology prior authorizations, comfortable working independently in a remote environment, knowledgeable about insurance carriers and medical necessity criteria, and committed to patient-focused service.