Referral and Prior Auth Rep-Imaging
Core
Manages department referrals, coordinates patient appointments, and obtains prior authorizations from insurance carriers for imaging and procedures.
Role type
Referral and Prior Authorization Representative
Builds
Patient care pathways and insurance approval workflows
Domain
Healthcare administration / Medical Imaging
Required skills
Medical terminology, insurance authorization protocols, electronic health record systems, data analysis, patient advocacy, scheduling coordination
Preferred skills
Surgical/appointment scheduling software, complex medical case management
Responsibilities
Manage department referrals and coordinate scheduled visits; Acquire insurance authorizations for visits and testing; Prepare and submit complex prior authorization requests to insurance carriers; Process incoming and outgoing referrals; Track patient compliance with treatment plans; Resolve insurance denials and coordinate peer-to-peer reviews.
Seniority
Entry-level, hands-on IC