Prior Authorization Specialist

Iowa Radiology P C•Clive, IA

8d•Onsite

About The Position

We are seeking a skilled and dedicated Prior Authorization Specialist to join our healthcare team. Iowa Radiology is a patient-centered practice that promotes a more compassionate approach to medicine. We provide our employees the ability to bring their authentic selves to work every day, providing compassionate care for our patients in a collaborative, supportive work environment. We want YOU to join the Iowa Rad family! We truly care about our employees, their health and well-being, and their career goals and aspirations. The ideal Prior Authorization Specialist will play a crucial role in helping us continue to be the premier provider of radiologic services in Iowa by securing timely insurance authorizations, supporting patient access to care, and ensuring accurate, complete documentation.

Requirements

High school graduate or equivalent.
Two or more years of medical prior authorization, referral, or insurance verification experience required.
Knowledge of payor requirements, medical terminology, and CPT/ICD-10 coding.
Must have a fundamental knowledge of typing and filing techniques.
Must be able to read, write, and speak fluent English.
Excellent verbal and written communication skills, with the ability to convey complex information to non-technical stakeholders.
Strong organization and attention to detail.
Continuous speaking, hearing, and visual effort.
Must have the ability to communicate effectively and work independently.
Continuous mental and visual concentration requiring attention-to-detail and accuracy.
Must possess manual dexterity to operate computer and other office equipment.
Ability to perform repetitive tasks associated with technology use (phone, computer, applications, and software).
Must be able to bend, stoop, kneel, or crouch as part of job functions.
Ability to lift and carry up to twenty-five (25) pounds when necessary.

Responsibilities

Verify patient insurance coverage and obtain prior authorizations through payor portals, phone, and fax.
Manage imaging orders and ensure authorizations are secured before scheduled exams.
Upload clinical documents that support authorization requests and track each request until a decision is made.
Handle denials, peer-to-peer reviews, and appeals in coordination with providers, patients, and insurers.
Monitor Teams messages and respond to questions and inquiries from staff and referring offices in a timely and professional manner.
Initiate good public relations and communicate effectively with patients, office personnel, and referring physicians' offices.
Become proficient in RIS, Epic, and payor portals, as well as Microsoft Teams and the multi-line phone system.
Attend staff meetings.
Report problems related to staffing, morale, work methods, and procedures to the Supervisor.
Functions other than those described above due to extenuating circumstances.