Prior Authorization Representative (Remote)

Envision Radiology is looking for a Remote Full Time Prior Authorization Representative to join our team!
Open to AL, AZ, CO, FL, ID, LA, MO, NE, NC, OK, TX, UT, VA & WI Markets
Schedule will be 8 hour shifts Monday - Friday between 7AM and 6PM | Position Pay Range $17.75 - $21.40
Targeted start date is May 5th, 2025

Summary/Objective

The Prior Authorization Representative supports the Centralized Services Department by performing all tasks required to obtain referrals/authorizations and verifying patients’ insurance coverage under the direction of the Centralized Services Supervisor.

Essential Functions

1. Notifies insurance companies of services being rendered, and obtains any necessary authorizations, ensuring notification and verification is complete for each order.

2. Obtains and verifies any necessary additional demographic and/or billing information.

3. Assists in identifying authorization issues and ensures that insurance information has been accurately obtained.

4. Works daily queues according to department directives to ensure all payer-specific authorization requirements are met and authorizations successfully obtained while consistently meeting department productivity standards.

5. Provides quality customer service to all patients and customers through prompt and courteous professional communication.

6. Interfaces with provider’s offices and medical staff to ensure all necessary documentation is obtained for purposes of pursuing a successful authorization approval.

7. Documents accurately into the Electronic Medical Record (EMR) system all actions, interactions, and authorizations surrounding the insurance process for each patient.

8. Participates in peer-to-peer learning and development.

9. Other duties as assigned.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Competencies

1. Communication Proficiency.

2. Technical Capacity

3. Organizational Skills.

4. Time Management.

5. Thoroughness.

Supervisory Responsibility

This position has no supervision responsibilities.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to use hands and fingers to handle, feel or operate objects, tools or controls, and reach with hands and arms. The employee is frequently required to talk and hear.

Travel

No travel is expected for this position.

Job Qualifications

Minimum Qualifications/Experience:

 One plus year of experience in healthcare pre-authorizations

 Familiarity with ICD-10 and CPT coding

 Detail oriented, self-motivated, a problem solver and a team player

 Ability to navigate multiple computer screens and browsers quickly and accurately

 Ability to excel in a very fast-pace team environment

 Ability to continuously “exceed” company and customer expectation

 Strong communication skills & professional demeanor

Education/Certifications:

 Minimum of High School diploma or equivalent (GED) – continuing education preferred.

Additional Eligibility Qualifications

None required for this position.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Other duties may be assigned as needed by supervision.

Compliance

Adheres to Envision’s Code of Conduct and Compliance Policies and attends annual Compliance training as set forth by the Company.

Company Benefits

Below is a list of benefits that are offered to employees, once eligibility is met.

 Health Benefits: Medical/Dental/Vision/Life Insurance

 Company Matched 401k Plan

 Employee Stock Ownership Plan

 Paid Time Off + Paid Holidays

 Employee Assistance Program

OSHA Exposure Rating: 1

It is reasonably anticipated NO employees in this job classification will have occupational exposure to blood and other potentially infectious body fluids.

Envision Radiology is an equal opportunity employer (M/F/D/V). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.