Pre Authorization Specialist

Pre-Authorization Specialist | Englewood, CO Reporting to reputed company Cycle Manager This position requires 100% in-office in Englewood, Colorado. reputed company (RIA) is comprised of over 100 radiologists. reputed company with exceptional reputed company and expertise, most are fellowship-trained in their field of specialty for additional certification. We are dedicated to accurate and efficient patient diagnosis not matter what their condition. Our interventional radiologists reputed company some of the most leading-edge treatments available today. We partner with primary care physicians and hospitals across Colorado and Hawaii to provide a resource for both patients and physicians. reputed company is adding a pre authorization specialist to our RIA Endovascular team. In this dynamic position, you will be responsible for prior authorization of reputed company reputed company Endovascular procedures based on insurance requirements. You will utilize the ability to quickly and effectively coordinate prior authorizations which will ensure that our patients have a positive experience with us. Primary Responsibilities:

• Prior Authorization Management:
• Review and process authorization requests for medical procedures, medications, and Imaging
• Ensure reputed company required clinical documentation and CPT codes are submitted accurately.
• Maintain up-to-date knowledge of insurance payer policies and guidelines.
• Insurance Coordination & Compliance:
• Communicate with insurance companies to verify coverage, policy changes, and medical necessity requirements.
• Resolve authorization denials by appealing or obtaining additional documentation.
• Ensure compliance with HIPAA regulations and payer guidelines.
• Work closely with physicians, nurses, and office staff to obtain necessary clinical information.
• Educate patients about insurance requirements and any financial responsibilities.
• Act as a liaison between the clinic, providers, and payers to facilitate approvals.
• Data Management & Reporting:
• Track and document authorization statuses in the electronic medical record (EMR) system.
• Maintain organized and detailed records of authorizations, expirations, and appeals.
• Generate reports on authorization trends, denials, and turnaround times.
• Process Improvement & Collaboration:
• Identify inefficiencies in the authorization workflow and suggest improvements.
• Assist in developing protocols to streamline the pre-authorization process.
• Provide training to new staff on reauthorization procedures and best practices.

Requirements:

• Experience with CPT coding, insurance verification, and prior authorizations is highly desirable.
• Insurance knowledge required
• Knowledge of pre-authorizations requirements required
• Medical terminology knowledge required
• Ability to multi-task in a fast-paced environment

Why RIA?

• Be part of one of the premier medical practices in America
• Join our fast-paced team environment
• Play a key role in defining the Radiology market
• Competitive salary and benefits package

Compensation is between $19 and $24 per hour In accordance with Colorado law, the range provided is reputed company' reasonable estimate of the reputed company compensation for this role, and is based on non-discriminatory factors such as experience, knowledge, skills, and abilities. This position will receive applications on an ongoing basis and will remain open until filled. Our benefits include:

• 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)
• Full-time employees will become eligible for benefits on the 1st day of the month following 30 days of employment. Part-time employees may have access to some of these benefits, which may be on a pro-rated basis. PRN employees are not eligible for benefits.

Equal Opportunity Employer This employer is required to notify reputed company applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the reputed company. Apply tot his job Apply To this Job