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Prior Authorization Specialist- MRI & Imaging

Orthopaedic Associates Of Michigan
Full-time
On-site
Grand Rapids, Michigan, United States
Healthcare Insurance and Claims

Job Description


Title: Prior Authorization Specialist - MRI & Imaging

Location: 1111 Leffingwell Ave. NE, Grand Rapids, MI 49525 (Candidates must live in Michigan or be willing to relocate.)

Hours: Full-Time (40 Hours/Week): M-F, 8AM-5PM

Work Environment: Remote, with the ability to come onsite for trainings and meetings.


About Us

Orthopaedic Associates of Michigan (OAM) is proud to be West Michigan’s most established orthopedic practice. Our physicians and team members provide exceptional, individualized care for patients of all ages. As the most comprehensive independent provider of musculoskeletal care in the region, we provide total care from diagnosis, to treatment, and all the way through rehabilitation. 

Patients at OAM will have access to our Specialized Surgeons, Physical and Occupational Therapists, MRI and X-ray services, and orthopedic bracing. Patients are also able to receive care from our Bone Health Clinic, OAM Now Urgent Orthopaedic Care Clinic, and Surgery Center at MidTowne – all of which are committed to optimizing their treatment outcomes. 

Our teams work together to maximize and adjust treatment quickly and easily, resulting in a smoother, faster recovery for patients. From neck to toe, and from traumatic injuries to chronic conditions, patients will receive compassionate care that will allow them to embrace their full potential. Patient goals are our goals – we will restore their health so they are functioning as fully as possible in the activities they love at home, work, and in everyday life.


Position Summary

We are seeking experienced professionals with significant prior-authorization or pre-certification experience, supporting our multiple Surgeons, providers and ancillary services. This role will involve a robust knowledge and background in MRI & Imaging. We are interested in candidates that are searching for a remote opportunity with some expectation of hybrid availability – must be able to train on-site for 4-5 weeks in Grand Rapids, Michigan and attend meetings on-site as needed.

Our ideal candidates will have excellent communication and organizational skills and at least two years of experience in a medical office. They will be proficient in their knowledge of anatomy, physiology and medical terminology. The ideal candidates will possess a strong working knowledge of medical billing, insurance, authorizations or pre-certifications.  Familiarity or experience with coding would be helpful.   


Essential Responsibilities

  • Verify correct procedural and diagnostic codes and insurance verification.
  • Communicate referral status to clinical team and with facility where procedure is performed; ensures that referrals have been processed accurately and in a timely manner to coincide with patient treatment plan.
  • Assign appropriate ICD10 and CPT codes prior to procedure based on documentation and booking slip.


Required & Preferred Qualifications

Education, Training, and Experience:

  • Required:
    1. 1+ year(s) of experience with prior-authorizations for MRI/imaging.
    2. Experience working with multiple insurance types.
  • Preferred:
    1. 1+ years of experience in an orthopedic setting.
    2. CPC (or the ability to obtain)

Specific Skills, Knowledge, and Abilities:

  • Strong data entry skills.
  • Patient focused mindset and compassionate approach.
  • Strong interpersonal communication skills.
  • Ability to handle a high volume of work and manage multiple tasks simultaneously.
  • High organizational skills and excellent attention to detail.
  • Strong professional appearance.
  • Knowledge of Microsoft Office and Windows based computer applications

Motor, Sensory, and Physical Requirements:

  • Ability to come onsite for trainings and meetings.
  • Ability to stand and/or sit for long periods of time.
  • Manual dexterity required to operate modern exercise and office equipment.
  • Normal or correctible range of hearing and eyesight.
Apply now
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