Radiology Prior Authorization Specialist

Trinity Health; United States; Remote; USD 55,000 - 90,000; Full time

Job summary

Trinity Health is seeking a Full-time Authorization Specialist to review, submit, monitor and respond to prior authorizations for high tech radiology services and DME across multiple offices.

You will verify medical history, liaise with insurers, update EMR, and ensure timely approvals, while mentoring teammates and supporting office operations.

This role requires knowledge of ICD-10/CPT, strong communication, and the ability to work in a fast-paced healthcare environment.

Qualifications

• 1-3 years’ clinical experience; 3–5 years’ experience with prior authorizations.
• Knowledge of major health plans and insurance processes.
• Experience obtaining medical necessity authorizations for multiple offices.
• Strong knowledge of imaging modalities.
• Familiarity with ICD-10/CPT coding.

Responsibilities

• Review, submit, monitor and respond to prior authorizations for high tech radiology and DME.
• Communicate with ordering providers and insurance representatives.
• Verify patient history and documentation in charts.
• Update EMR with approval or denial information.
• Obtain urgent authorizations same day or next day.
• Mentor other team members and train staff.

Skills

Medical terminology

Insurance processes

ICD-10 coding

Data collection

Communication skills

EMR proficiency

Excel skills

Team collaboration

Education

Undergraduate degree or Associate’s degree in healthcare

Tools

EMR software

Microsoft 365

Excel

Job description

Trinity Health is seeking a Full-time Authorization Specialist to review, submit, monitor and respond to prior authorizations for high tech radiology services and DME across multiple offices.

You will verify medical history, liaise with insurers, update EMR, and ensure timely approvals, while mentoring teammates and supporting office operations.

This role requires knowledge of ICD-10/CPT, strong communication, and the ability to work in a fast-paced healthcare environment.