Prior Authorizations Specialist

X--ray-Associates-of-Nm; Albuquerque (NM); On-site; USD 42,000 - 60,000; Full time

Job summary

X-Ray Associates of New Mexico is seeking a Revenue Qualification Specialist to join our Revenue Cycle team. The role focuses on verifying insurance eligibility and benefits, securing prior authorizations, and preparing patient estimates to help patients understand their financial responsibilities prior to imaging services.

Responsibilities include communicating with patients, providers, and insurers, updating records, and supporting special Revenue Cycle projects.

Qualifications

• Minimum of two years of experience in insurance verification, prior authorizations, medical front office, or medical accounts receivable.
• Knowledge of medical insurance processing and medical terminology.
• Strong attention to detail and organizational skills.
• Excellent customer service abilities and communication.
• Ability to learn multiple software systems in a fast-paced environment.

Responsibilities

• Verify insurance eligibility and benefits for scheduled patients.
• Obtain and document prior authorizations from insurance carriers.
• Prepare patient cost estimates and assist with payment arrangements.
• Update patient demographic and insurance information.
• Communicate with patients, referring providers, and insurance companies regarding authorization and benefit information.
• Support Revenue Cycle operations and special projects as assigned.

Skills

Insurance verification

Prior authorizations

Medical front office

Medical accounts receivable

Medical terminology

Attention to detail

Organizational skills

Customer service

Software proficiency

Education

High school diploma or equivalent

Job description

Description

X-Ray Associates of New Mexico is seeking a Revenue Qualification Specialist to join our Revenue Cycle team. This position is responsible for verifying insurance eligibility and benefits, obtaining prior authorizations, preparing patient estimates, and assisting patients with understanding their financial responsibility prior to scheduled imaging services.

Key Responsibilities:

• Verify insurance eligibility and benefits for scheduled patients.
• Obtain and document prior authorizations from insurance carriers.
• Prepare patient cost estimates and assist with payment arrangements.
• Update patient demographic and insurance information.
• Communicate with patients, referring providers, and insurance companies regarding authorization and benefit information.
• Support Revenue Cycle operations and special projects as assigned.

Requirements

• High school diploma or equivalent.
• Minimum of two years of experience in insurance verification, prior authorizations, medical front office, or medical accounts receivable.
• Knowledge of medical insurance processing and medical terminology.
• Strong attention to detail, organizational skills, and customer service abilities.
• Ability to work effectively in a fast-paced environment and learn multiple software systems.