Referral & Authorization Specialist - Interventional Neuroradiology

Invision Sally Jobe / Radiology Imaging Associates • Cherry Hills Village, CO

5d • $21 - $24 • Onsite

About The Position

Radiology Imaging Associates (RIA) is comprised of over 100 radiologists, many of whom are fellowship-trained in their specialty. We are dedicated to accurate and efficient patient diagnosis and perform leading-edge treatments. We partner with primary care physicians and hospitals across Colorado and Hawaii to provide a resource for both patients and physicians.

Requirements

• High school diploma or equivalent.
• At least one year of experience in a medical office, patient-access, referral, insurance-verification, prior-authorization, scheduling, billing, or revenue-cycle environment.
• Basic understanding of health insurance terminology, including eligibility, benefits, deductibles, copayments, coinsurance, referrals, prior authorization, and medical necessity.
• Experience working with electronic health records, practice-management systems, payer portals, or document-imaging systems.
• Strong data-entry, organizational, communication, and follow-up skills.
• Ability to manage multiple work queues, deadlines, and competing priorities.
• Ability to communicate professionally with patients, physicians, payer representatives, and outside provider offices.
• Ability to handle protected health information confidentially.

Nice To Haves

• Two or more years of referral, prior-authorization, patient-access, or revenue-cycle experience.
• Experience supporting interventional radiology, neuroradiology, neurology, neurosurgery, vascular services, hospital-based procedures, or another procedural specialty.
• Familiarity with Medicare, Medicaid, commercial insurance, and managed-care requirements.
• Experience reviewing CPT codes, diagnosis codes, authorization requirements, and medical-necessity documentation.
• Experience researching authorization-related denials or claim edits.
• Knowledge of payer portals and electronic referral-management systems.
• Medical terminology training or certification.
• Certified Revenue Cycle Representative, Certified Medical Administrative Assistant, Certified Professional Biller, or similar credential.

Responsibilities

• Receive and review incoming referrals, orders, clinical records, imaging reports, demographic information, and insurance documentation.
• Index referral documents accurately into the appropriate patient record, referral platform, work queue, or document-management system.
• Confirm that referrals contain the information required for clinical review, scheduling, authorization, and billing.
• Identify incomplete or inconsistent information and promptly contact the referring office for clarification or missing documentation.
• Maintain accurate referral statuses and document all outreach, follow-up efforts, and outstanding requirements.
• Route referrals to the appropriate physician, advanced practice provider, clinical reviewer, scheduling team, or operational department.
• Monitor referral work queues and aging to prevent referrals from remaining unresolved.
• Prepare and send referrals, orders, clinical records, imaging reports, and supporting documentation to outside providers and facilities.
• Confirm receipt of outgoing referrals when appropriate.
• Coordinate with outside organizations to determine referral requirements, scheduling processes, and documentation needs.
• Track outstanding outgoing referrals and follow up to support continuity of care.
• Communicate referral status and next steps to patients, referring offices, and internal clinical teams.
• Protect patient information and follow HIPAA and organizational privacy requirements when transmitting records.
• Verify patient insurance coverage, eligibility, benefits, network participation, and authorization requirements.
• Determine whether authorization, notification, predetermination, or referral approval is required before services are provided.
• Initiate and submit authorization requests through payer portals, telephone, fax, or other required methods.
• Gather and submit clinical documentation necessary to support medical-necessity review.
• Track pending authorization requests and follow up with payers until a determination is received.
• Accurately document authorization numbers, effective dates, approved services, units, service locations, servicing providers, and expiration dates.
• Confirm that the approved procedure, provider, facility, and date of service align with the scheduled service.
• Escalate urgent, delayed, denied, or administratively complex authorization cases to the appropriate clinical or RCM leader.
• Assist with peer-to-peer coordination, reconsideration requests, and authorization-related appeals by collecting and organizing required information.
• Communicate authorization status and unresolved financial-clearance issues to scheduling and clinical teams before the date of service.
• Review patient accounts for demographic, registration, insurance, authorization, and referral-related errors.
• Correct or route identified account issues to the appropriate department.
• Assist with claim-status research and basic payer follow-up.
• Review authorization-related claim edits, denials, and requests for additional information.
• Compare claim information with the authorization to identify discrepancies involving procedure codes, units, dates, providers, or places of service.
• Obtain and submit missing authorization documentation when permitted.
• Support denial-prevention efforts by identifying recurring referral, registration, documentation, or authorization issues.
• Document account activity clearly and consistently within the billing or practice-management system.
• Assist with work queues, reports, audits, and special RCM projects as assigned.
• Refer coding, clinical, compliance, payment-posting, and complex denial issues to the appropriate subject-matter expert.
• Serve as a responsive point of contact for patients, referring offices, outside facilities, payers, and internal departments.
• Explain referral and authorization requirements in a professional and patient-friendly manner.
• Provide timely updates regarding missing information, authorization delays, scheduling barriers, and next steps.
• Maintain positive working relationships with physicians, clinical staff, scheduling teams, payer representatives, and outside organizations.
• Escalate concerns that may delay care, create financial risk, or negatively affect the patient experience.

Benefits

• Medical, dental, and vision insurance
• Term life insurance, AD&D, and EAP
• Long Term Disability
• Generous Paid Time Off
• Paid holidays
• Voluntary income protection options (ie. supplemental life insurance, accident, critical illness)
• Profit-sharing 401(k) retirement plan
• Tuition reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED