FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in prior authorization processes within radiology and diagnostic imaging, with a strong focus on collaboration, accuracy, and process improvement. Proficient in managing high-volume authorizations and navigating payor-specific guidelines while maintaining effective communication with providers and patients.
Highest-signal resume keywords
Prior Authorization ExperienceRadiology Billing ExpertiseLeadership ExperienceFamiliarity With PayorsProcess Improvement Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Prior Authorization ProcessingBilling In RadiologyClinical Documentation GatheringInsurance VerificationAuthorization Request SubmissionDenial ManagementWorkflow StreamliningOncologic Imaging KnowledgeAI-Powered Tools AdaptabilityDetail-Oriented Work
Soft Skills
Collaborative CommunicationEmpathyAdaptabilityMeticulous Attention To DetailTeam Leadership
Tools & Technologies
AthenahealthNextGenEviCoreCarelon
Industry Keywords
Radiology Benefit ManagersPayor PoliciesImaging AuthorizationsDiagnostic ImagingHealthcare Regulations
About the role
Key responsibilities & impact- Process prior authorizations directly, often at high volume
- Serve as a go-to resource for other Ascertain Assistants
- Collaborate with Ascertain leadership and product teams to shape AI-powered prior authorization workflows
- Work closely with radiology practices and imaging centers to reduce administrative burden and streamline workflows
- Manually process authorizations and oversee automated submissions for MRI, CT, PET, nuclear medicine, diagnostic radiology, interventional radiology, and related referrals
- Review and verify insurance information and patient eligibility
- Gather clinical documentation from ordering providers and imaging teams, including indications, prior imaging, and supporting records
- Submit prior authorization requests to payors according to established protocols and payor-specific imaging guidelines
- Monitor and track requests for timely processing and resolution, including scheduling-sensitive and urgent studies
- Respond to provider, patient, and payor inquiries about authorization status
- Manage denials and peer-to-peer requests and support appeals
- Maintain accurate records of authorization requests, approvals, and denials
- Collaborate with internal teams to resolve authorization issues and improve process efficiency
- Stay current on payor policies, radiology benefit manager requirements, regulations, and industry trends affecting imaging authorizations
Requirements
What you’ll need- 4+ years of experience with prior authorization and billing in radiology and/or diagnostic imaging
- Experience with athenahealth and/or NextGen
- Familiarity with major payors, including UnitedHealthcare, Aetna, and Blue Cross Blue Shield
- Familiarity with radiology benefit managers such as EviCore and Carelon (formerly AIM)
- Experience with prior authorization and billing in oncology, including oncologic imaging and PET/CT
- Hands-on leadership experience, such as Team Lead, Supervisor, or informal leadership
- Roll-up-your-sleeves approach
- Detail-oriented, meticulous work and authorization accuracy
- Collaborative communication with providers, teammates, and cross-functional stakeholders
- Adaptability between manual workflows and AI-powered tools
- Empathy when interacting with providers and patients
- Process-driven approach to established workflows and process improvement
Benefits
Comp & perks- Equity
- Opportunity to make a direct impact on healthcare organizations and patient care
- Opportunity to work with AI-powered healthcare technology
- Broad exposure to multiple specialties, external stakeholders, and departments across Ascertain