Invision Sally Jobe / Radiology Imaging Associates ยท 5 days ago
Senior Prior Authorization and Benefits Eligibility Specialist
Englewood, CO
Full-time
Onsite
Mid, Senior Level
$22/hr - $29.50/hr
2+ years expInvision Sally Jobe is a network of imaging centers focused on providing high-quality imaging services in the South Denver area. The Senior Authorization and Benefits Eligibility Specialist is responsible for managing complex authorization and insurance verification processes, ensuring compliance with payer guidelines, and serving as a resource for the team.
CommercialHealth CareHealth Diagnostics
Responsibilities
Perform detailed eligibility and benefits verification for MRI, CT and other radiology services
Secure prior authorizations from commercial and government payers, ensuring compliance with payer-specific guidelines
Identify and resolve authorization issues to prevent delays in patient care
Work closely with referring providers to obtain necessary clinical documentation for authorization approvals
Analyze payer trends to identify common denial reasons and implement proactive solutions
Collaborate with the billing and denial management teams to resolve authorization-related denials and appeals
Serve as a resource for complex cases, assisting with escalations and troubleshooting issues
Maintain strong relationships with insurance representatives to stay updated on policy changes
Educate clinical and administrative staff on payer authorization requirements
Document all authorization activities in the system with accuracy and detail
Recommend workflow improvements to enhance efficiency and reduce authorization turnaround times
Ensure compliance with HIPAA and payer-specific regulations
Qualification
Required
Minimum of 2-3 years of experience in medical insurance authorization and benefits verification, preferably in radiology or diagnostic imaging
In-depth knowledge of commercial, Medicare, and Medicaid payer policies and authorization requirements
Experience working with electronic health records (EHR), radiology information systems (RIS), and payer portals
Strong problem-solving skills with the ability to work independently on complex cases
Excellent communication and organizational skills with attention to detail
Ability to manage multiple priorities in a fast-paced environment
Must be able to read, write, and speak in English
Preferred
5+ years of experience in medical insurance authorization and benefits verification, preferably in radiology or diagnostic imaging
Experience with Epic, Cerner, or other RIS/PACS/EHR systems
Knowledge of medical coding (CPT, ICD-10) related to radiology services
Prior experience training or mentoring junior staff
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
Company
Invision Sally Jobe / Radiology Imaging Associates
Invision Sally Jobe is a network of imaging centers built and managed through a partnership between Radiology Imaging Associates and HealthOne.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Patricia Whelan Downey
Chief Executive Officer
Sean O'Donnell
Chief Technology Officer
Company data provided by crunchbase