Authorization & Account Verification Specialist 2

Position Summary

The Authorization & Verification Specialist II plays a key role in supporting revenue cycle operations by verifying patient insurance coverage and managing prior authorizations. This position requires advanced knowledge of payer requirements, analytical and strong problem-solving abilities, and effective communication with payors, providers, and internal teams. The goal is to prevent service delays and denials while maintaining full compliance with payer and regulatory standards.

Essential Job Duties and Responsibilities

• Review provider orders and referrals to confirm accuracy of patient demographics, insurance details, CPT codes, and required clinical documentation
• Independently verify insurance eligibility, benefits, and authorization requirements across a wide range of payers
• Initiate, manage, and follow up on complex prior authorizations in alignment with payor guidelines and required timelines
• Validate authorization information received from referring offices to ensure completeness and accuracy
• Document all authorization activities, payer interactions, and outcomes thoroughly in the patient record
• Communicate authorization status, clinical review needs, issues, and denials promptly to providers, staff, payers, and patients
• Identify barriers to authorization and proactively escalate or resolve issues to support timely patient access to care
• Assist with MRI audits, Auth on Script reporting, and identifying target exams with available appointment slots
• Ensure compliance with payer policies, departmental workflows, and HIPAA regulations

Knowledge, Skills, and Abilities

• Ability to manage multiple priorities independently in a fast-paced environment
• Strong patient-focused customer service and professional communication skills
• High level of accuracy in data entry with strong computer proficiency
• Solid working knowledge of medical terminology, ICD-10, and CPT coding
• Analytical, problem-solving, and critical-thinking skills
• Effective de-escalation skills when addressing patient or provider

Education and Experience Requirements

• High school diploma or GED required
• Demonstrated knowledge of insurance eligibility, benefits, and prior authorization processes
• 3-6 years of experience in a physician office or healthcare administrative setting preferred
• Experience with EPIC EMR or similar electronic medical record systems preferred

Work Smart, Live Well

The success of Advanced Radiology is earned every day through our dedication to quality patient care and continual improvement of the patient experience. Our success allows us to enjoy a wide range of benefits designed to support and enhance our lives, both at work and at home.

Health Benefits

• Medical and Prescription Drug Coverage
• Dental Coverage
• Vision Coverage
• Health Savings Account (HSA) with Matching Employer Contribution

Additional Benefits

• Generous Paid Time Off (PTO)
• Paid Holidays
• 401(k) Plan with Employer Contribution
• Annual Profit-Sharing Plan Contribution
• Paid Opt-Out Benefit Option

Basic Life and Accident Insurance

Advanced Radiology is an Equal Opportunity Employer, offering outstanding compensation and benefits plans designed to reward and retain exceptional employees.