Radiology Preauthorization Specialist I

MedStar Health; Baltimore (MD); On-site; USD 26,000 - 45,000; Full time

Job summary

MedStar Health is seeking a Preauthorization/Precertification Specialist in Baltimore, MD with strong radiology authorization knowledge to verify eligibility and secure required approvals before services.

The role supports patients and providers by obtaining referrals, coordinating with payers, and ensuring accurate data entry for billing. Familiarity with UB04/HCFA, CPT/ICD-10, and MS Office is preferred; 1–2 years in patient accounting or related fields is expected.

Qualifications

• Working knowledge of payer authorization and clearance processes.
• Basic working knowledge of UB04 HCFA 1500 or equivalent and payer responses.
• Familiarity with CPT/ICD-10 coding and medical terminology.
• Strong communication, analytical, interpersonal and organizational skills.
• Proficient in hospital registration/billing systems and MS Excel & Word.
• Ability to type 35 words per minute.

Responsibilities

• Verify eligibility and obtain pre-authorizations for procedures, admissions, medications and equipment as required.
• Initiate and track authorizations for scheduled procedures and ensure correct insurance information is on file.
• Maintain communication with payers, providers and patients regarding approvals and scheduling.
• Enter data into IDX/SMs/Invision systems and ensure accurate billing data is captured for claims.
• Monitor authorization work queues and resolve missing numbers or documentation.
• Stay current with regulatory changes affecting pre-authorization requirements.
• Meet departmental quality benchmarks and accuracy standards.

Skills

Payer authorization

Eligibility verification

Communication skills

Medical terminology

CPT/ICD-10 familiarity

MS Excel & Word

Typing speed 35 WPM

Education

High School Diploma or GED

Job description

MedStar Health is seeking a Preauthorization/Precertification Specialist in Baltimore, MD with strong radiology authorization knowledge to verify eligibility and secure required approvals before services.

The role supports patients and providers by obtaining referrals, coordinating with payers, and ensuring accurate data entry for billing. Familiarity with UB04/HCFA, CPT/ICD-10, and MS Office is preferred; 1–2 years in patient accounting or related fields is expected.