Referral & Prior Auth Rep III-Imaging
Core
Manages department referrals, coordinates patient appointments, and secures insurance prior authorizations for imaging and procedures to ensure patient access to care.
Role type
Senior administrative specialist (referral and prior authorization)
Builds
Patient appointment schedules and insurance authorization approvals
Domain
Healthcare administration / Medical Imaging
Required skills
Medical terminology, insurance policy interpretation, ICD/CPT coding, electronic health record management, data analysis, patient advocacy, complex scheduling, conflict resolution
Preferred skills
Surgical/appointment scheduling software, experience with Epic system
Technologies
Epic, electronic medical records
Responsibilities
Manage department referrals and coordinate scheduled visits; acquire insurance authorizations for visits and testing; process incoming and outgoing referrals; communicate with patients, families, and clinical staff to resolve barriers; track patient compliance and data; escalate cases requiring medical assessment; draft letters of medical necessity for denied claims.
Seniority
Mid-level, hands-on IC