Pre-Authorization Specialist

Invision Sally Jobe / Radiology Imaging Associates

. Secure prior authorizations from commercial and government payers while ensuring compliance with payer-specific guidelines .

Posted 11/3/2026full-timeEnglewood • Colorado • United StatesJuniorMid-Level💰 $20 - $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in prior authorization workflows and insurance policies, with a strong focus on compliance with HIPAA and payer-specific regulations. Proficient in analyzing payer trends and implementing solutions to enhance efficiency in authorization processes.

Highest-signal resume keywords

Prior Authorization ExpertiseKnowledge of Payer PoliciesExperience with EHR SystemsStrong Problem-Solving SkillsExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Insurance AuthorizationsKnowledge of Medical CodingCPT CodingICD-10 CodingAuthorization CompliancePayer-Specific RegulationsWorkflow ImprovementDenial ManagementClinical Documentation AnalysisAuthorization Documentation

Soft Skills

Attention to DetailOrganizational SkillsAbility to Manage Multiple PrioritiesIndependent WorkCollaboration Skills

Tools & Technologies

Electronic Health Records (EHR)Radiology Information Systems (RIS)Payer PortalsEpicCerner

Industry Keywords

RadiologyDiagnostic ImagingMedicareMedicaidHIPAA Compliance

About the role

Key responsibilities & impact

Secure prior authorizations from commercial and government payers while ensuring compliance with payer-specific guidelines
Identify and resolve authorization issues to prevent delays in patient care
Work with referring providers to obtain clinical documentation for authorization approvals
Analyze payer trends to identify common denial reasons and implement proactive solutions
Collaborate with billing and denial management teams on authorization-related denials and appeals
Maintain relationships with insurance representatives and stay updated on policy changes
Document authorization activities accurately and in detail
Recommend workflow improvements to enhance efficiency and reduce authorization turnaround times
Ensure compliance with HIPAA and payer-specific regulations
Serve as a subject matter expert in prior authorization workflows and insurance policies

Requirements

What you’ll need

Minimum of 2-3 years of experience in medical field, 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
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: 1-3 years of experience in medical insurance authorizations, preferably in radiology or diagnostic imaging
Preferred: Experience with Epic, Cerner, or other RIS/PACS/EHR systems
Preferred: Knowledge of medical coding (CPT, ICD-10) related to radiology services
Preferred: Prior experience training or mentoring junior staff

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Term life insurance
AD&D
EAP
Short Term Disability
Long Term Disability
PTO
Holiday pay
Voluntary supplemental life insurance
Accident insurance
Critical illness insurance
Profit sharing 401(k) retirement plan
Tuition reimbursement
Benefits eligibility for full-time employees on the first of the month following 30 days of employment