Radiology Prior Authorization Pro

Hartford HealthCare; Hartford (CT); On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Hartford HealthCare in Hartford, CT seeks a Prior Authorization Specialist to process and submit radiology authorizations, communicate denials to physicians, and coordinate with patients, providers and insurers. The role requires EPIC experience, CPT/ICD-10 knowledge, and strong communication.

We offer a comprehensive benefits program and opportunities for career growth within Connecticut's largest healthcare network.

Qualifications

• High School Diploma or Equivalent required, Associate Degree in business or health administration, finance, or health systems management highly preferred.
• 2-3 years’ experience in the medical field, preferred
• 1-2 year experience with insurance authorization, preferred
• Experience working with Radiology strongly preferred
• Knowledge of CPT and ICD-10 coding practices
• Radiology billing and coding. Certified professional coder and experience in third party payer environment preferred.
• Medical Terminology
• Excellent communication skills. Communicates effectively with office staff, patients, and other appropriate parties.

Responsibilities

• Initiates prior authorization for all radiology exams requested by staff, providers, and or insurers.
• Documents all prior authorization activities and record activity in EPIC accurately.
• Prioritize and organizes all prior authorization activities
• Serve as a liaison between patient, insurer, and practice
• Prints and reviews the scheduled appointments up to three days in advance to ensure proper obtaining of authorizations and pre-certification prior to services being rendered
• Identifies and resolves problems with the scope of the job duties. Notifies manager of any situation or issue that is out of the ordinary.
• Work on denials and write off’s
• Prepares written communication to notify appropriate staff of authorization updates and or changes for insurance carrier.
• Responsible to update patient changes of insurances and coverage issues in a timely manner
• Perform other related work, as assigned by manager

Skills

Communication skills

Medical Terminology

CPT ICD-10 knowledge

EPIC system

Education

High School Diploma or Equivalent

Associate Degree in business/health administration/finance/health systems management

Tools

EPIC

Job description

Hartford HealthCare in Hartford, CT seeks a Prior Authorization Specialist to process and submit radiology authorizations, communicate denials to physicians, and coordinate with patients, providers and insurers. The role requires EPIC experience, CPT/ICD-10 knowledge, and strong communication.

We offer a comprehensive benefits program and opportunities for career growth within Connecticut's largest healthcare network.