Senior Radiology Prior Authorization Specialist

Dana-Farber Cancer Institute; Boston (MA); On-site; USD 44,000 - 48,000; Full time

Job summary

The Radiology Authorization Specialist at Dana-Farber Cancer Institute manages medical-necessity based authorizations for diagnostic imaging. Working in a fast-paced environment, you will apply payer guidelines, review clinical documents, and create concise prior authorization requests.

You will verify insurance eligibility, respond to payer questions, and follow up on denied coverage while delivering high-quality customer service to patients and clinical staff.

Qualifications

• High school diploma or GED required; associate or bachelor’s degree preferred.
• 0–1 year of relevant healthcare/authorization experience preferred.
• Strong knowledge of medical terminology and payer policies.
• Ability to handle confidential patient information.

Responsibilities

• Review and prioritize radiology authorization work queues.
• Prepare payer-specific prior authorization requests.
• Verify insurance eligibility and benefits.
• Interpret policy criteria and apply guidelines to requests.
• Review patient progress notes, lab reports, and imaging reports to identify required documentation.
• Respond to payer questions and coordinate provider-to-plan interventions.
• Follow up with patients on denied coverage and provide solutions.
• Post-claim denial follow-up to overturn radiology-related denials.
• Perform other duties as assigned.

Skills

Medical terminology

Payer rules

Prior authorization

Analytical skills

Confidentiality

Independence

Fast-paced environment

Education

High school diploma or GED

Associate or Bachelor’s degree preferred

Tools

EMR systems

Microsoft Office

Job description

The Radiology Authorization Specialist at Dana-Farber Cancer Institute manages medical-necessity based authorizations for diagnostic imaging. Working in a fast-paced environment, you will apply payer guidelines, review clinical documents, and create concise prior authorization requests.

You will verify insurance eligibility, respond to payer questions, and follow up on denied coverage while delivering high-quality customer service to patients and clinical staff.