What are the responsibilities and job description for the Pre Authorization Specialist position at RIA?
Pre-Authorization Specialist | Englewood, CO
Reporting to Supervisor, Patient Services
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, Kansas, and Hawaii to provide a resource for both patients and physicians.
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.
Radiology Imaging Associates offers a comprehensive benefits package including medical, dental, vision, term life insurance, AD&D, EAP, Short Term Disability, Long Term Disability, PTO and holiday pay for eligible employees. There are also options for voluntary income protection benefits i.e. supplemental life insurance, accident, and critical illness, profit sharing 401(k) retirement plan, and tuition reimbursement. Part-time employees may have access to some of these benefits, which may be on a pro-rated basis. Full-time employees will become eligible for benefits on the first day of the month following 30 days of employment.
Salary : $19 - $24
