Authorization Coordinator

Midstate Radiology Associates•Wallingford, CT

20h•Onsite

About The Position

Join Midstate Radiology Associates (MRA) as a Full Time Authorization Coordinator working on-site in Wallingford, CT. This position is responsible for obtaining insurance authorizations from carriers to assure proper payment is made for exams. Successful candidates will be comfortable with medical terminology and communicating effectively with patients, insurance carriers and physicians. MRA offers competitive starting compensation based on qualifications and experience, with an opportunity for advancement after six months of service.

Requirements

High school diploma or equivalent.
Must demonstrate strong knowledge of HMO insurance carrier products, including authorization and referral requirements, as well as the ability to communicate clearly and tactfully, verbally and in writing.
Must possess good computer skills, strong organizational skills and attention to detail.

Nice To Haves

Prior medical insurance experience, preferred.

Responsibilities

Obtains documents, verifies and conducts follow-up on insurance authorizations and insurance eligibility as required for scheduled exams. Consults with supervisor on complex and/or difficult situations.
Enters data accurately into system, applying CPT codes to match authorization for exam. Consults with Modality Protocoller, Clinical Managers, or technologist, as needed to ensure accuracy and smooth workflow. Maintains CPT code authorization files based on managed care contracts. Performs clerical duties as needed.
Contacts insurance companies to obtain prior authorization and predetermination for imaging exams ordered by providers. Checks insurance eligibility to ensure that the information provided matches the insurance carrier’s database information.
Prepares written communication to notify appropriate staff of authorization updates and/or changes for insurance carriers. In support of marketing efforts to enhance relationships with referring physician offices, interacts with external customers to inform and educate regarding authorization procedures. Works collegially and professionally with all internal and external staff members and physicians.
In cooperation with the Business Office, works insurance denials by researching, sending appeal letters and making appropriate contact with insurance companies or billing staff. Performs quality assurance checks of scheduled and recently performed exams. Provides recommendations for policy and procedure changes to management to prevent or limit denials.
Expected to schedule certain exams based on direction from the Manager.