[Hiring] Radiology Authorization Specialist @Dignity Health Medical Group

Role Description

As our Pre-Authorization Radiology Specialist, you will bridge the gap between physician offices, insurance carriers, and radiology clinics to ensure seamless patient care and guaranteed payment for services.

• Verify patient eligibility and secure authorizations for radiology exams.
• Manage the complexities of insurance requirements, ensuring alignment with the correct CPT and ICD-10 codes.
• Scrub assigned modality/Imaging Center to ensure each appointment has been verified.
• Verify insurance is active and eligible to be seen at DHAI.
• Confirm with insurance carrier if authorization is required for scheduled exam.
• Submit and obtain necessary authorization for correct CPT code.
• Confirm scheduled exam matches the referral/CPT code/authorization.
• Provide the RMD with necessary insurance contact information and patient information for authorization approval when peer-to-peer is needed.

This position is work from home within California. We will provide you with the equipment needed to work from home, including a laptop, docking station, dual monitors, and accessories.

Qualifications

• High School Graduate General Studies or High School GED General Studies.
• Proficiency in health insurance eligibility and authorization requirements.
• Knowledge of government program regulations, Medi-Cal, Medicare, MIA, C.C.S., and other third-party payers.
• Ability to problem solve; ability to analyze data and recommend changes.
• Strong customer service skills.
• Ability to work collaboratively with a culturally diverse staff and patient/family population.
• Ability to work independently with minimum supervision.
• Basic PC skills.
• Basic knowledge of medical terminology.
• Excellent oral/written communication; articulate and concise oral communication.
• Ability to write clearly and concisely.

Requirements

• High School Graduate General Studies or High School GED General Studies.
• Proficiency in health insurance eligibility and authorization requirements.
• Knowledge of government program regulations, Medi-Cal, Medicare, MIA, C.C.S., and other third-party payers.
• Ability to problem solve; ability to analyze data and recommend changes.
• Strong customer service skills.
• Ability to work collaboratively with a culturally diverse staff and patient/family population.
• Ability to work independently with minimum supervision.
• Basic PC skills.
• Basic knowledge of medical terminology.
• Excellent oral/written communication; articulate and concise oral communication.
• Ability to write clearly and concisely.