Pre Authorization Specialist

Pre-Authorization Specialist | Englewood, CO
Reporting to Revenue Cycle Manager

Employment Type: Full Time

Radiology Imaging Associates (RIA) is comprised of over 100 radiologists. All with exceptional skill and expertise, most are fellowship-trained in their field of specialty for additional certification. We are dedicated to accurate and efficient patient diagnosis not matter what their condition. Our interventional radiologists perform some of the most leading-edge treatments available today. We partner with primary care physicians and hospitals across Colorado and Hawaii to provide a resource for both patients and physicians.

Radiology Imaging Associates is adding a pre authorization specialist to our RIA Endovascular team. In this dynamic position, you will be responsible for prior authorization of all Radiology Imaging Associates Endovascular procedures based on insurance requirements. You have will utilize the ability to quickly and effectively coordinate prior authorizations which will ensure that our patients have a positive experience with us.

Primary Responsibilities:

• Prior Authorization Management:
  • Review and process authorization requests for medical procedures, medications, and Imaging
  • Ensure all required clinical documentation and CPT codes are submitted accurately.
  • Maintain up-to-date knowledge of insurance payer policies and guidelines.
• Insurance Coordination & Compliance:
  • Communicate with insurance companies to verify coverage, policy changes, and medical necessity requirements.
  • Resolve authorization denials by appealing or obtaining additional documentation.
  • Ensure compliance with HIPAA regulations and payer guidelines.
• Provider & Patient Communication:
  • Work closely with physicians, nurses, and office staff to obtain necessary clinical information.
  • Educate patients about insurance requirements and any financial responsibilities.
  • Act as a liaison between the clinic, providers, and payers to facilitate approvals.
• Data Management & Reporting:
  • Track and document authorization statuses in the electronic medical record (EMR) system.
  • Maintain organized and detailed records of authorizations, expirations, and appeals.
  • Generate reports on authorization trends, denials, and turnaround times.
• Process Improvement & Collaboration:
  • Identify inefficiencies in the authorization workflow and suggest improvements.
  • Assist in developing protocols to streamline the pre-authorization process.
  • Provide training to new staff on reauthorization procedures and best practices.

Requirements:

• Experience with CPT coding, insurance verification, and prior authorizations is highly desirable. 
• Insurance knowledge required
• Knowledge of pre-authorizations requirements required
• Medical terminology knowledge required
• Strong verbal/written communication skills
• Excellent phone etiquette and customer service skills
• Ability to multi-task in a fast-paced environment

Why RIA?

• Be part of one of the premier medical practices in America
• Join our fast-paced team environment
• Play a key role in defining the Radiology market
• Competitive salary and benefits package

Compensation is between $19 and $24 per hour

In accordance with Colorado law, the range provided is Radiology Imaging Associates' reasonable estimate of the base compensation for this role, and is based on non-discriminatory factors such as experience, knowledge, skills, and abilities. This position will receive applications on an ongoing basis and will remain open until filled.

Our benefits include:

• Medical, dental, and vision insurance

• Term life insurance, AD&D, and EAP

• Long Term Disability

• Generous Paid Time Off

• Paid holidays

• Voluntary income protection options (ie. supplemental life insurance, accident, critical illness)

• Profit-sharing 401(k) retirement plan

• Tuition reimbursement

Full-time employees will become eligible for benefits on the 1st day of the month following 30 days of employment. Part-time employees may have access to some of these benefits, which may be on a pro-rated basis. PRN employees are not eligible for benefits.

Salary : $19 - $24