Invision Sally Jobe / Radiology Imaging Associates
Senior Prior Authorization and Benefits Eligibility Specialist
Invision Sally Jobe / Radiology Imaging Associates, Englewood, Colorado, us, 80151
Senior Prior Authorization and Benefits Eligibility Specialist
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Senior Prior Authorization and Benefits Eligibility Specialist
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Invision Sally Jobe / Radiology Imaging Associates
Englewood, CO | Reporting to Team Lead, Revenue Cycle Management | Full Time | 100% in‑office
Invision Sally Jobe (ISJ) is a network of imaging centers built and managed through a partnership between Radiology Imaging Associates and HealthOne. Our imaging centers are conveniently located throughout the South Denver area and offer a variety of exams using state‑of‑the‑art equipment, including MRI, CT, digital mammography, ultrasound, pain management, DXA, X‑Ray, and image‑guided biopsies. Our mission is to improve the health of patients in the communities we serve by providing the highest quality imaging and associated medical care.
Primary Responsibilities
Prior Authorization & Eligibility Verification:
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.
Problem Solving & Denial Prevention:
Analyze payer trends to identify common denial reasons and implement proactive solutions.
Collaborate with 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.
Communication & Coordination:
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.
Process Improvement & Compliance:
Recommend workflow improvements to enhance efficiency and reduce authorization turnaround times.
Ensure compliance with HIPAA and payer‑specific regulations.
Qualifications
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 Qualifications
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.
Compensation for this role: $22.00 to $29.50 per hour. This estimate reflects a reasonable base for the position, based on nondiscriminatory factors such as experience, knowledge, skills, and abilities. The position will remain open until filled.
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 (including supplemental life insurance, accident, critical illness)
Profit‑sharing 401(k) retirement plan
Tuition reimbursement
Full‑time employees will become eligible for benefits on the 1st day of the month following 30 days of employment. Part‑time employees may have access to some of these benefits, pro‑rated. PRN employees are not eligible for benefits.
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Senior Prior Authorization and Benefits Eligibility Specialist
role at
Invision Sally Jobe / Radiology Imaging Associates
Englewood, CO | Reporting to Team Lead, Revenue Cycle Management | Full Time | 100% in‑office
Invision Sally Jobe (ISJ) is a network of imaging centers built and managed through a partnership between Radiology Imaging Associates and HealthOne. Our imaging centers are conveniently located throughout the South Denver area and offer a variety of exams using state‑of‑the‑art equipment, including MRI, CT, digital mammography, ultrasound, pain management, DXA, X‑Ray, and image‑guided biopsies. Our mission is to improve the health of patients in the communities we serve by providing the highest quality imaging and associated medical care.
Primary Responsibilities
Prior Authorization & Eligibility Verification:
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.
Problem Solving & Denial Prevention:
Analyze payer trends to identify common denial reasons and implement proactive solutions.
Collaborate with 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.
Communication & Coordination:
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.
Process Improvement & Compliance:
Recommend workflow improvements to enhance efficiency and reduce authorization turnaround times.
Ensure compliance with HIPAA and payer‑specific regulations.
Qualifications
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 Qualifications
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.
Compensation for this role: $22.00 to $29.50 per hour. This estimate reflects a reasonable base for the position, based on nondiscriminatory factors such as experience, knowledge, skills, and abilities. The position will remain open until filled.
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 (including supplemental life insurance, accident, critical illness)
Profit‑sharing 401(k) retirement plan
Tuition reimbursement
Full‑time employees will become eligible for benefits on the 1st day of the month following 30 days of employment. Part‑time employees may have access to some of these benefits, pro‑rated. PRN employees are not eligible for benefits.
#J-18808-Ljbffr