Top 18 Prior authorization specialist Jobs in Rhode Island

Authorizations Specialist
Rhode Island Medical Imaging —Warwick, RI
- Monday to Friday
- Hybrid work
- Bilingual
- Computer literacy
- HIPAA
- Profit sharing
- Loan repayment program
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Referral and Authorization Specialist
Care New England Health System —Warwick, RI
- Full-time
- Bilingual
- Customer service
- HIPAA
Authorizations Specialist (Part-Time)
Rhode Island Medical Imaging —Warwick, RI
- Part-time
- Hybrid work
- Bilingual
- Computer literacy
- HIPAA
- Profit sharing
- Loan repayment program
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8d
Authorization Specialist/Biller
Care New England Health System —Warwick, RI
- Full-time
- English
- Research
- Mid-level
Referral Specilist
Brown University Health —Providence, RI
- $19.03 - $31.39 an hour
- 8 hour shift
- High school diploma or GED
- Data entry
- 2 years
Referral Specialist
Brown University Health —Providence, RI
- $19.03 - $31.39 an hour
- Part-time
- Mid-level
- High school diploma or GED
- 2 years
Insurance Authorization Specialist
South County Hospital —Wakefield, RI
- From $20.25 an hour
- Full-time
- Hospital
- Customer service
- Mid-level
- Health insurance
- Dental insurance
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Referral Coordinator
The Providence Community Health Centers, Inc. —Providence, RI
- Full-time
- Background check
- Microsoft Outlook
- HIPAA
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Referral Specialist Gastroenterology
Brown University Health —East Providence, RI
- $19.03 - $31.39 an hour
- 8 hour shift
- Computer literacy
- Mid-level
- High school diploma or GED
Pre-Certification Specialist
CharterCARE of Rhode Island —Providence, RI
- Full-time
- Computer literacy
- Writing skills
- Medical office experience
Referral Coordinator
Brown University Health —Providence, RI
- $18.00 - $25.82 an hour
- 8 hour shift
- Hospital
- Mid-level
- High school diploma or GED
MG Patient Service Specialist
Brown University Health —Providence, RI
- $18.13 - $29.90 an hour
- 8 hour shift
- Microsoft Excel
- Microsoft Outlook
- High school diploma or GED
Referral Coordinator (multiple vacancies)
East Bay Community Action Program —Barrington, RI
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Paid training
- 403(b) matching
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Medical Secretary
RI Primary Care —Narragansett, RI
- $37,440 - $45,760 a year
- Microsoft Excel
- Microsoft Outlook
- Ability to walk for extended periods
- Paid holidays
- Health insurance
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Referral Coordinator
Brown University Health —Providence, RI
Knowledge of front office operations in addition to clinical knowledge for triaging referrals and determining when the patient needs to be seen.
$18.00 - $25.82 an hour
Referral Coordinator
The Providence Community Health Centers, Inc. —Providence, RI
Knowledge of state and federal health care programs, including Medicaid, Medicare and other public benefits programs, preferred.
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Eye Specialists of Ohio —Lancaster, OH
Job responsibilities include: checking in and greeting patients, collecting copayments and coinsurances, entering insurance and demographic information,…
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Prior Authorization Specialist
WSD —Westerville, OH
Must have prior experience with insurances and prior authorizations. Collaborate with clinical staff to ensure timely approvals for patient treatments.
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Authorizations Specialist

Rhode Island Medical Imaging -
Warwick, RI

Quick Apply

Job Details

Benefits

Profit sharing
Loan repayment program
Health insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off

Qualifications

Insurance third-party billing
Client interaction via phone calls

Full Job Description

SUMMARY:

This position will transition to a hybrid role once the employee is fully trained and receives management approval. Training will be completed on-site at our corporate office in Warwick, RI.

Responsible for obtaining prior authorizations, verifying insurance, and the collection of selected accounts for Rhode Island Medical Imaging. This position also assists patients with questions regarding coverage and payment issues and serves as a key component of the cash flow for the institution.

SCHEDULE:

Monday-Friday 9:30 AM-6:00 PM

PRINCIPLE DUTIES AND RESPONSIBILITIES:

Obtain prior authorizations from insurance companies for selected exams and document accordingly within the company system.
Obtain insurance verifications and out of pocket expenses for patients prior to their exams.
Communicate out of pocket expenses to the patient and note accounts accordingly.
Assist patients with questions regarding their benefits and out of pocket expenses in an efficient and professional manner.
Work daily eligibility reports for hospital sites to verify insurance information.
Effectively utilize billing and scheduling software to ensure efficient workflow.
Understand the elements associated with completing the HCFA 1500 billing form for payor(s). Understand and resource billing guidelines for each payor; stay informed on related changes.
Utilize CPT codes, HCPC codes, and ICD-10 codes in daily workflow. Use department and payor resources to ensure that accounts are accurate and complete.
Take initiative and alert Management to possible issues or concerns.
Crosstrain and fill in for other team members when directed by Management.
As needed, enlist the help of the Supervisor to ensure that accounts remain collectable.
Stay informed on insurance changes regarding policy and coverage guidelines.
Maintain professionalism at all times and adhere to all company policies and procedures.
Consistently apply the corporate values of respect, honesty, fairness, and constant pursuit of excellence in improving local patient health status through the provision of customer-friendly, geographically accessible, and high-value services within the environment of a diagnostic imaging company.
Ensure that all interactions are in compliance with HIPAA and federal compliance regulations.
Participate in meetings as requested.
Perform other duties as assigned.

BASIC KNOWLEDGE/SKILLS:

Must have knowledge of third-party billing requirements.
Ability to maintain sensitivity to the delicate nature of collecting payments for medical services while remaining effective in securing those payments.
Ability to adapt, in a timely manner, to changes in collection rules as defined by State and/or Federal law and/or Management.
Ability to work in a team environment.
Must be able to make decisions and manage/prioritize workloads.
Must have excellent telephone and interpersonal skills.
Bilingual is a plus.

EXPERIENCE:

One year of Prior Authorization experience preferred.

EDUCATION

High school diploma or equivalent.
Additional courses in insurance billing, computer basics, and medical terminology preferred.

PHYSICAL DEMANDS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. This description is not intended to be a complete statement of the position, but rather to act as a guide to the general work to be performed. The requirements are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual's competencies and customer requirements impact the actual role performed.

Join an award-winning organization! With numerous private, state-of-the-art medical diagnostic imaging facilities, join the team that has been providing Rhode Island with imaging excellence for over 80 years! The American College of Radiology has named RIMI one of the first outpatient diagnostic imaging Centers of Excellence in the country and the first in Rhode Island. RIMI also has the honor of being named an eight-time winner of Providence Business News' Healthiest Employers of Rhode Island Award, most recently in 2025!

RIMI offers best-in-class benefits to eligible employees including multi-tiered health plans, flexible spending accounts, generous paid time off, 401(k) plan with profit sharing component, uniform reimbursement, company "swag," yearly reimbursement for continuing medical education, educational assistance (reimbursement) program, student loan repayment program, and career development opportunities. Enjoy competitive pay and all in our innovative culture that consistently provides the highest levels of quality, safety, technology, and patient care.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

prior authorization specialist jobs in rhode island

Authorizations Specialist

Referral and Authorization Specialist

Authorizations Specialist (Part-Time)

Authorization Specialist/Biller

Referral Specilist

Referral Specialist

Insurance Authorization Specialist

Referral Coordinator

Referral Specialist Gastroenterology

Pre-Certification Specialist

Referral Coordinator

MG Patient Service Specialist

Referral Coordinator (multiple vacancies)

Medical Secretary

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