Radiology Prior Authorization Specialist

Trinity Health MI; Ann Arbor (MI); On-site; USD 42,000 - 60,000; Full time

Job summary

Trinity Health MI in Ann Arbor seeks a Full-time Prior Authorization Specialist to review, submit, and monitor medical necessity authorizations for high-tech radiology services and DME across multiple offices. You will verify patient history, contact insurers, and secure approvals.

The role requires strong knowledge of ICD-10/CPT coding, insurance processes, and experience with EMR systems. Excellent communication with providers and payers, data collection, and timely follow-up are essential.

Qualifications

• Undergraduate or Associate degree in healthcare or related field.
• Licensure as LPN, Radiology Technician/Technologist, or Medical Assistant as relevant.
• 1-3 years clinical experience; 3-5 years insurance referrals or prior authorization experience.

Responsibilities

• Review and submit prior authorizations for high-tech radiology services and DME.
• Communicate with ordering providers, practice staff and insurance representatives.
• Verify patient history and documentation to support testing and authorization.
• Obtain authorizations from insurers and update EMR with outcome.
• Monitor in-basket, email, and fax communications; follow up promptly.

Skills

Medical terminology

Insurance processes

ICD-10/CPT coding

EMR systems

Communication with payers

Education

Undergraduate or Associate degree in healthcare

Licensed Practical Nurse (MI) or Radiology/Medical Assistant certification

Tools

EMR systems

Microsoft Office (Excel)

Job description

Trinity Health MI in Ann Arbor seeks a Full-time Prior Authorization Specialist to review, submit, and monitor medical necessity authorizations for high-tech radiology services and DME across multiple offices. You will verify patient history, contact insurers, and secure approvals.

The role requires strong knowledge of ICD-10/CPT coding, insurance processes, and experience with EMR systems. Excellent communication with providers and payers, data collection, and timely follow-up are essential.