Authorizations Representative

Spire Orthopedic Partners•Warwick, RI

About The Position

The Authorizations Representative works with staff and external entities to obtain MRI authorizations promptly by providing accurate clinical and demographic information. The role communicates authorization details, benefits, and co-payments to patients and schedules MRI exams and related physician follow-up visits. It also monitors MRI orders and requests, tracks authorization status, facilitates peer-to-peer reviews when needed, and provides medical records in support of MRI requests. Authorization activity is documented across systems including Centricity, Exscribe, and Health iPass.

Requirements

High school graduate or equivalent.
Any combination of education, training, and experience that demonstrates the ability to perform the duties of the position.
Experience with Microsoft Office, including Word, Excel, and PowerPoint.

Responsibilities

Obtain MRI orders and requests for target locations by monitoring the EMR system, phone, online channels, and email.
Submit MRI authorization requests online or by phone.
Investigate MRI authorization and benefit information online or by phone.
Communicate authorization details, benefits, and co-payments to patients before exams.
Update authorization status throughout the process and confirm receipt of MRI authorization.
Schedule MRI exams and physician follow-up visits.
Facilitate peer-to-peer reviews for MRI requests as needed.
Provide medical records in support of MRI requests.
Document authorization activity in Centricity, Exscribe, and Health iPass.
Perform other duties as assigned.