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Radiology / Healthcare Pre-Authorization Specialist

Royal Solutions Group Jefferson City, MO
  • Posted: over a month ago
  • $30,000 to $45,000 Annually
  • Full-Time
  • Benefits: Medical, 401k, Dental

We are seeking a Pre-Authorization Specialist to become an integral part of our team!

The Pre-Authorization Specialist core duties consist of contacting insurance companies and other third-party administrators to determine pre-authorization and/or medical necessity requirements for basic and high-tech outpatient radiology exams and procedures. Obtaining the pre-authorization prior to the scheduled service being performed. Liaisons with clients, physicians and physician office staff when needed to obtain additional clinical documentation.

The ideal candidate will have direct experience with radiology and/or the pre-authorization process with insurance companies and third-party administrators. The ability to communicate clearly and professionally with payers and customers is a must as we feel that direct communication with the client provides a competitive advantage.

Responsibilities:

  • Confirm all necessary documents required for accurate submission of the pre-authorization request are available and communicate with clients when additional documentation is required
  • Responsible for verifying eligibility and obtaining pre-authorizations as needed per insurance company requirements
  • Contact insurance companies and third-party administrators to ensure prior approval requirements are met, present necessary medical information such as history and diagnosis.
  • Responsible for tracking, following up on, and extending authorizations from insurance companies and third-party administrators in a timely manner
  • Perform other job-related duties as assigned

Qualifications:

  • Experience in customer service
  • Radiology experience a plus
  • Knowledge of medical terminology
  • Knowledge of insurance benefits
  • Experience with authorizations
  • Good written and verbal communication skills
  • Organization and multi-tasking skills

Royal Solutions Group

Why Work Here?

Awesome team, great company, innovative technology, lots of opportunity for growth and challenges!

Royal is a leading provider of services and customized software to the Health Care industry. Headquartered in White Plains, New York we serve a broad client base across North America. Royal's leadership team combined, offer over 100 years of collective experience in technology, financial services, management consulting, and healthcare fields. Together these complimentary disciplines ensure best practices and tailored innovation in the application of technology to solve our client's unique challenges and achieve measurable business results. We understand information is more than just getting data from point A to point B. There are many operational and technology factors involved to support the needs of health care firms. Information in the right hands, at the right time, and for the right cost remains a key factor that differentiates successful companies from the rest of the pack. Our product offerings focus on patient and provider workflows, delivered through a suite of integrated products. Royal Solutions Group owns and operates RoyalPay, Inc., its revenue cycle management division, and its own Health Information Exchange (HIE), offering centralized data management and robust interoperability capabilities with any third party system.

Address

1804 Southwest Blvd, Suite B Jefferson City, MO 65109
Jefferson City, MO
USA

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