Authorization Coordinator

Midstate Radiology Associates•Wallingford, CT

8d•Onsite

About The Position

The Authorization Coordinator obtains insurance authorizations from carriers to help ensure proper payment for exams. The role involves communicating with patients, insurance carriers, physicians, and internal staff, and requires comfort with medical terminology. The position is full-time and on-site in Wallingford, Connecticut, with a Monday–Friday first-shift schedule of either 8:00 AM–4:30 PM or 8:30 AM–5:00 PM, totaling 40 scheduled hours per week. Starting pay is $21.00–$26.30, based on qualifications and experience. After six months of service, there is an opportunity to advance to Authorization Coordinator II with a pay increase.

Requirements

High school diploma or equivalent.
Strong knowledge of HMO insurance carrier products, including authorization and referral requirements.
Ability to communicate clearly and tactfully, verbally and in writing.
Good computer skills.
Strong organizational skills and attention to detail.

Nice To Haves

Prior medical insurance experience.

Responsibilities

Obtain, verify, document, and follow up on insurance authorizations and eligibility for scheduled exams; consult a supervisor about complex or difficult situations.
Enter data accurately into the system and apply CPT codes that match exam authorizations; coordinate with the Modality Protocoller, Clinical Managers, or technologists as needed.
Maintain CPT code authorization files based on managed care contracts and perform clerical duties as needed.
Contact insurance companies to obtain prior authorizations and predeterminations for imaging exams ordered by providers.
Check insurance eligibility to confirm that information provided matches the insurance carrier’s database.
Prepare written communications notifying appropriate staff about authorization updates or changes.
Interact with external customers to explain authorization procedures in support of relationships with referring physician offices; work professionally with internal and external staff and physicians.
Work insurance denials with the Business Office by researching, sending appeal letters, and contacting insurance companies or billing staff as appropriate.
Perform quality assurance checks of scheduled and recently performed exams and recommend policy or procedure changes to management to prevent or limit denials.
Schedule certain exams as directed by the Manager.