Radiology Prior Authorization Specialist

Trinity Health

Ann Arbor (MI)

On-site

USD 45,000 - 65,000

Full time

5 days ago

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Job summary

Trinity Health is seeking an experienced reviewer for prior authorizations in radiology and DME. You will interact with providers, billing staff, and insurance representatives to secure authorizations and ensure accurate documentation in the EMR.

The role emphasizes accuracy, speed, and compliance with HIPAA and Trinity Health policies. The candidate should have an undergraduate or associate degree in healthcare and knowledge of ICD-10/CPT coding, with 1–3 years of related experience in medical

Qualifications

Undergraduate degree or Associate’s degree in healthcare or graduate of an accredited program.
Proficiency in medical terminology and understanding of insurance processes.
Experience with obtaining medical necessity authorizations and documentation.

Responsibilities

Review, submit, monitor, and respond to prior authorizations for radiology and/or DME.
Communicate with ordering providers and insurance representatives.
Review patient history and docs to identify supporting information for testing.
Perform data collection and data review assignments.
Obtain authorizations from insurers and update EMR with approval/denial.
Monitor inboxes and follow up timely on correspondence.
Obtain urgent authorizations same day or next day.
Verify procedural/diagnostic codes and insurance verification.
Monitor authorizations/denials and follow up as needed.
Mentor other team members and assist with training.
Support other offices and participate in required meetings.