TRA Medical Imaging

Prior Authorization Specialist

• Obtain prior authorizations for imaging procedures including MRI, CT, PET, Nuclear Medicine, Fluoroscopy, Interventional Radiology, Mammography, Ultrasound, X-ray, and Bone Densitometry
• Verify insurance eligibility, benefits, and authorization requirements
• Ensure correct CPT and ICD-10 coding for all scheduled exams
• Contact referring physician offices and insurance carriers to obtain required documentation
• Review medical records to confirm medical necessity
• Enter authorization numbers and detailed documentation into the RIS system
• Educate patients on insurance and authorization requirements
• Reschedule patients when authorization is pending
• Provide price quotes and explain financial assistance options
• Maintain HIPAA compliance and patient confidentiality
• Collaborate with technologists, front desk staff, and scheduling teams to ensure exam accuracy
• Ensure scheduled imaging examinations are authorized for the correct facility, meet medical necessity guidelines, and comply with insurance carrier and HIPAA requirements
• Work under established guidelines and immediate supervision within Health Information Management, Patient Access, and Scheduling functions

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Prior Authorization Specialist