Prior Authorization Coordinator

hace 3 días

Ciudad de México CDMX OneImaging A tiempo completo

**Position Overview**:As a Prior Authorization Coordinator, you will be responsible for managing the submission, tracking, and resolution of prior authorization (PA) requests for advanced imaging services. You will play a crucial role in streamlining the authorization process to expedite patient care, collaborating closely with Patient Care Navigators to address PA-related inquiries, and ensuring clear communication with patients. Additionally, you will review and route new imaging referrals to ensure appropriate processing and workflow.

**Key Responsibilities**:

- **Prior Authorization Screening**: Review incoming imaging referrals to identify cases requiring prior authorization and route them into the appropriate workflows for processing.
- **PA Submission and Tracking**: Submit prior authorization requests for advanced imaging services on behalf of our member patients and monitor their status to ensure timely processing. Work proactively to resolve any issues that may cause delays, helping to expedite patient care.
- **Collaboration and Support**: Act as the primary PA contact for Patient Care Navigators and patients, providing updates and addressing inquiries related to prior authorization requirements and status.
- **New Referral Review**: Assist in the review and initial processing of new imaging referrals, ensuring each referral is correctly screened for PA needs and directed to the appropriate channels.

**Qualifications**:

- **Experience in Prior Authorization**: 3-5 years of experience with medical imaging prior authorizations, including both submission and follow-up.
- **Provider and Health Plan Coordination**: Minimum of 2 years of experience liaising with medical providers and health plan utilization management (UM) teams to ensure smooth authorization workflows.
- **Communication and Problem-Solving Skills**: Exceptional interpersonal skills, with strong abilities in communication, active listening, and issue resolution.
- **Performance and Efficiency**: Demonstrated success in managing PA requests in a high-volume, fast-paced environment with a focus on efficiency and patient satisfaction.
- **Attention to Detail**: Proven track record for accuracy and thoroughness in processing prior authorization requests and managing documentation.

This role is an excellent opportunity for professionals dedicated to enhancing patient experiences within a collaborative and dynamic team. Join OneImaging and make a tangible impact on patient-centered radiology care.

Pay: From $20,121.00 per month

**Experience**:

- prior auth submission and followup: 2 years (preferred)
- liaising with imaging providers and health plan UM teams: 2 years (preferred)

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