Authorization Coordinator

Posted 3 Days Ago
Be an Early Applicant
Wallingford, CT, USA
In-Office
21-26 Hourly
Entry level
Hospital Care
The Role
Obtains and verifies insurance authorizations and eligibility for imaging exams, contacts carriers, applies CPT codes, maintains authorization records, and supports denial resolution. The role communicates with patients, physicians, insurance companies, and internal teams; performs quality checks, prepares authorization updates and appeals, schedules certain exams, and recommends process improvements to reduce denials. This is a full-time, on-site position working Monday through Friday on the first shift.
Summary Generated by Built In

Join Midstate Radiology Associates (MRA) as a Full Time Authorization Coordinator working on-site in Wallingford, CT.

Position Schedule: Mon - Fri, 1st Shift (8:00 AM - 4:30 PM or 8:30 AM - 5:00 PM)

For complete listing of all open positions, visit www.midstateradiology.com/career-opportunities

Compensation: MRA offers competitive starting compensation based on qualifications and experience. Starting pay for this position is between $21.00 - $26.30. Opportunity for advancement to Authorization Coordinator II, with pay increase, after six months of service. 

Job Summary:

    The Authorization Coordinator is responsible for obtaining insurance authorizations from carriers to assure proper payment is made for exams. Successful candidates will be comfortable with medical terminology and communicating effectively with patients, insurance carriers and physicians. 

Key Accountabilities:

1. Obtains documents, verifies and conducts follow-up on insurance authorizations and insurance eligibility as required for scheduled exams. Consults with supervisor on complex and/or difficult situations.
 
 2. Enters data accurately into system, applying CPT codes to match authorization for exam. Consults with Modality Protocoller, Clinical Managers, or technologist, as needed to ensure accuracy and smooth workflow. Maintains CPT code authorization files based on managed care contracts. Performs clerical duties as needed. 
 
 3. Contacts insurance companies to obtain prior authorization and predetermination for imaging exams ordered by providers. Checks insurance eligibility to ensure that the information provided matches the insurance carrier’s database information.
 
 4. Prepares written communication to notify appropriate staff of authorization updates and/or changes for insurance carriers. In support of marketing efforts to enhance relationships with referring physician offices, interacts with external customers to inform and educate regarding authorization procedures. Works collegially and professionally with all internal and external staff members and physicians.
 
 5. In cooperation with the Business Office, works insurance denials by researching, sending appeal letters and making appropriate contact with insurance companies or billing staff. Performs quality assurance checks of scheduled and recently performed exams. Provides recommendations for policy and procedure changes to management to prevent or limit denials.

6. Expected to schedule certain exams based on direction from the Manager.

The preceding functions have been provided as examples of the types of work performed by employees assigned to this job classification.  Management reserves the right to add, modify, change or rescind the work assignments of different positions and to make reasonable accommodations so that qualified employees can perform the essential functions of the job.

Qualifications Guidelines:

Education Required:   

  • High school diploma or equivalent.

Desirable: 

  • Prior medical insurance experience, preferred. 

Knowledge:

  • Must demonstrate strong knowledge of HMO insurance carrier products, including authorization and referral requirements, as well as the ability to communicate clearly and tactfully, verbally and in writing. 

Skills/Abilities:

  • Must possess good computer skills, strong organizational skills and attention to detail
  • May occasionally be required to carry up to 10 lbs. Sitting will be required 90% of the time. 

Our team at Midstate Radiology Associates benefits from a diverse workforce and we welcome anyone to apply: 

Midstate Radiology Associates is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

To learn more about Midstate Radiology Associates, including more information on employee benefits and our company culture, please visit our website: www.MidstateRadiology.com


Shift Schedule: Mon - Fri, 1st Shift (8:00 AM - 4:30 PM or 8:30 AM - 5:00 PM).
Scheduled Weekly Hours: 40

Skills Required

  • High school diploma or equivalent
  • Strong knowledge of HMO insurance carrier products, including authorization and referral requirements
  • Clear and tactful verbal and written communication skills
  • Good computer skills
  • Strong organizational skills and attention to detail
  • Prior medical insurance experience
  • Ability to sit approximately 90% of the time and occasionally carry up to 10 pounds
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The Company
HQ: Meriden, Connecticut
153 Employees
Year Founded: 1955

What We Do

Founded in 1955, Midstate Radiology Associates, LLC has been a leader in diagnostic and therapeutic radiology for over 60 years. We provide a variety of comprehensive radiology imaging services, including low-dose digital X-ray, 3T MRI, CT scans, ultrasounds and 3D mammograms, as well as cutting-edge interventional procedures.

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