Top 34 Prior authorization specialist Jobs in Woonsocket, Ri

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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Revenue Cycle Specialist
Human Services Management Corporation —Milford, MA
- $23 - $26 an hour
- Full-time
- Hybrid work
- HIPAA
- Mid-level
- Office
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Front Office Coordinator
Sturdy Health —Attleboro, MA
- $23.71 - $36.14 an hour
- Full-time
- HIPAA
- Mid-level
- Outpatient experience
- Health insurance
- Dental insurance
2d
Authorization Specialist/Biller
Care New England Health System —Warwick, RI
- Full-time
- English
- Research
- Mid-level
Authorization Specialist
New England Life Care —Canton, MA
- $21 - $22 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Customer service
- Disability insurance
- Health insurance
Quick Apply
Practice Coordinator II
Dana-Farber Cancer Institute —Attleboro, MA
- $47,800 - $71,700 a year
- Full-time
- Hospital
- Mid-level
- 3 years
Inpatient Authorization Specialist-2
Brown University Health —Providence, RI
- $22.04 - $36.37 an hour
- 8 hour shift
- HIPAA
- Mid-level
- Office
1d
Referral Specialist
Brown University Health —Providence, RI
- $19.03 - $31.39 an hour
- 8 hour shift
- Spanish
- Hospital
- Mid-level
Referral Coordinator
The Providence Community Health Centers, Inc. —Providence, RI
- Full-time
- Background check
- Microsoft Outlook
- HIPAA
Quick Apply
Intake Specialist - Float, Adult Mental Health, Harrington Hospital - 40 hours, Various Shifts
UMass Memorial Health —Webster, MA
- $16.54 - $29.76 an hour
- 8 hour shift
- Spanish
- English
- High school diploma or GED
Patient Service Specialist
Brown University Health —Foxborough, MA
- $18.13 - $29.90 an hour
- 8 hour shift
- Microsoft Excel
- Microsoft Outlook
- High school diploma or GED
12d
Lead Medical Record Technician (ROI)
US Veterans Health Administration —Brockton, MA
- $57,150 - $74,297 a year
- Online Application
- Background check
- High school
- Writing skills
- Paid parental leave
- Paid holidays
6d
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
Pediatric Site Coordinator
Brown University Health —Providence, RI
- $20.96 - $34.61 an hour
- 8 hour shift
- Microsoft Excel
- Microsoft Outlook
- Hospital
Utilization Management Specialist
Elder Services of Worcester Area, Inc —Worcester, MA
- $48,262.50 - $49,276.50 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Computer literacy
- Office
- Mileage reimbursement
- Paid holidays
Quick Apply
7d
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
Denials & Appeals Specialist
American Addiction Centers —Worcester, MA
- $25.62 - $34.61 an hour
- Addiction Medicine
- Adults
- Research
- Health insurance
- Dental insurance
8d
Referral Coordinator (multiple vacancies)
East Bay Community Action Program —Barrington, RI
- Full-time
- Customer service
- HIPAA
- Mid-level
- Paid training
- 403(b) matching
Quick Apply
Medical Biller Part Time or Full Time
Eye Care Specialists —Norwood, MA
- $25 - $30 an hour
- Part-time
- Private practice
- Mid-level
- Organizational skills
- Paid holidays
- Disability insurance
Quick Apply
Billing Specialist
Veterans Inc. —Shrewsbury, MA
- From $26.44 an hour
- Online Application
- HIPAA
- Research
- 3 years
- 403(b) matching
- Paid parental leave
Quick Apply

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Authorizations Specialist

Rhode Island Medical Imaging -
Warwick, RI

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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 woonsocket, ri

Authorizations Specialist

Revenue Cycle Specialist

Front Office Coordinator

Authorization Specialist/Biller

Authorization Specialist

Practice Coordinator II

Inpatient Authorization Specialist-2

Referral Specialist

Referral Coordinator

Intake Specialist - Float, Adult Mental Health, Harrington Hospital - 40 hours, Various Shifts

Patient Service Specialist

Lead Medical Record Technician (ROI)

Referral Specialist Gastroenterology

Pediatric Site Coordinator

Utilization Management Specialist

MG Patient Service Specialist

Denials & Appeals Specialist

Referral Coordinator (multiple vacancies)

Medical Biller Part Time or Full Time

Billing Specialist

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