Job Overview The Pre-Authorization Specialist core duties consist of contacting insurance companies and other third-party administrators to determine pre-authorization and/or medical necessity requirements for basic and high-tech outpatient radiology exams and procedures. Obtaining the pre-authorization prior to the scheduled service being performed. Liaisons with clients, physicians and physician office staff when needed to obtain additional clinical documentation. The ideal candidate has direct experience with radiology and/or the pre-authorization process with insurance companies and third-party administrators. The ability to communicate clearly and professionally with payers and customers is a must as we feel that direct communication with the client provides a competitive advantage.

Responsibilities

• Responsible for Fast Auth
• Confirm all necessary documents required for accurate submission of the pre-authorization request are available and communicate with clients when additional documentation is required
• Responsible for verifying eligibility and obtaining pre-authorizations as needed per insurance company requirements
• Perform other job-related duties as assigned

Qualifications

• Experience in customer service
• Experience with authorizations
• Radiology Authorization experience required
• Knowledge of medical terminology and ICD 10 coding
• Knowledge of insurance benefits
• Good written and verbal communication skills
• Organization and multi-tasking skills
• Dedicated home office space with ability to secure hardware and access to PHI
• Reliable high speed internet (preferred fiber or cable)

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