Prior Authorization Representative

At Precision Imaging Centers, we are currently hiring a full time, remote Prior Authorization Billing Representative. You will need one year or more of prior experience working with authorizations, billing, medical insurance verification, benefits, and eligibility experience to be considered for this position. The hours are 8am to 4:30pm, Monday-Friday. This is a remote position that will require the technical skills and self-discipline to work from home.

The Radiology Prior Authorization Representative is responsible for gathering all pertinent information required for complete submission of prior authorization for imaging studies. The associate must accurately and timely complete the authorization form and submit it to through the appropriate channels. The representative is responsible for all follow-up phone calls on the authorization and documentation into the RIS system of the authorization status.

SCOPE OF ROLE AND RESPONSIBILITIES
Oversight and participation in all aspects of radiology prior authorizations process.

ESSENTIAL FUNCTIONS

• Verify the correct authorization form if applicable and plan to submit authorization through.
• Gather all necessary information from doctor’s offices to complete authorization.
• Responsible for the submission of authorization to the insurance plan.
• Responsible for all follow-up phone calls to the insurance company or doctor’s office for status of authorization or to request for additional information.
• Process and reverse online authorization cases as required.
• Responsible for maintaining required spreadsheets as necessary.
• Responsible for all documentation of authorization and status.
• Update Sales Staff with pertinent information as necessary.
• Meet benefit investigation process standards by completing assigned worklist tasks in a timely manner.
• Reporting to management when assistance is needed to complete the task.
• Participate in team meetings by sharing the details of cases worked.
• Able to work 7:00 AM through 6:00 PM shifts.

ADDITIONAL RESPONSIBILITIES

• Perform other duties assigned by manager/ supervisor/ lead.

QUALIFICATIONS & ABILITIES

• High school graduate with a minimum of one-year prior authorization experience preferred.
• Proven ability to work in a fast-paced environment.
• Excellent computer skills.
• Proficient in Microsoft Word and Excel.
• Knowledge of medical terminology and diagnosis codes associated with radiology patients and practices.
• Must be able to review medical histories and chart notes to garner required authorization information.
• Excellent written and verbal communication skills.
• Must be able to communicate with internal representatives, insurance companies and prescribe office personnel as appropriate to facilitate obtaining prior authorizations.
• Must be able to work both independently and collaboratively based on daily workload/demands.
• Must maintain a professional demeanor while interfacing with patients, customers and insurance plans.
• Ability to adhere to C.A.R.T. principles: Competence, Accountability, Respect, Trust.

REQUIRED EDUCATION/TRAINING AND/OR PROFESSIONAL EXPERIENCE

• High school Diploma or Equivalency.
• One year of medical insurance verification, benefits and eligibility experience.
• One year of previous experience in medical billing and authorizations.

EXPECTED PROFESSIONAL COMPETENCIES

• Critical Thinking
• Ability to Identify Problems
• Gather evidence through research
• Evaluate options & derive conclusions
• Follow Through/Detail-Oriented
• Executing through completion
• Follow detailed instructions
• Apply what others have developed

DIRECT REPORT

Reports to the Manager of Prior Authorizations

Job Type

Full-time Remote

Education

• High school or equivalent

This job is ideal for someone who is:

• Dependable -- more reliable than spontaneous
• People-oriented -- enjoys interacting with people and working on group projects
• Adaptable/flexible -- enjoys doing work that requires frequent shifts in direction
• Detail-oriented -- would rather focus on the details of work than the bigger picture
• Achievement-oriented -- enjoys taking on challenges, even if they might fail
• Innovative -- prefers working in unconventional ways or on tasks that require creativity

Why Consider Joining Our Team?

• Work/Life Balance and Remote Opportunities
• Full Time Positions are Benefit Eligible
• Benefits include Medical, Dental, Vision, PTO and 401k
• Supportive Team and Management
• Career Growth and Advancement Opportunities

Precision Imaging Centers is growing rapidly. We are adding new positions as we expand. Come grow your career with us!

Thank you for considering a career with Precision Imaging Centers!