Diagnostic Prior Authorization & Insurance Verification Specialist Gulf Coast Medical Center - Port Richey, FL Full-Time | Monday-Friday Starting at $21/hour; higher starting rate available based on relevant CT/MRI authorization experience Gulf Coast Medical Center is seeking an experienced Prior Authorization & Insurance Verification Specialist to join our Diagnostic Imaging team. We are looking for someone with hands-on experience verifying insurance benefits and obtaining prior authorizations for diagnostic testing. Experience obtaining CT and MRI prior authorizations is strongly preferred. This position requires someone who is organized, persistent, and comfortable managing authorizations from initial submission through final approval. The ideal candidate actively monitors pending cases, follows up with payers, obtains missing information, and escalates issues before they delay patient care. Responsibilities Verify insurance eligibility, benefits, and prior authorization requirements for diagnostic procedures Obtain prior authorizations through payer portals, utilization-management vendors, phone, fax, and other required methods Manage diagnostic imaging authorizations, including CT and MRI Review orders for CPT codes, diagnosis codes, and required clinical documentation Submit medical records and additional clinical information requested by payers Monitor pending authorizations and follow up on outstanding cases Identify cases requiring additional documentation, reconsideration, or peer-to-peer review Communicate with providers and clinical staff when additional information or physician action is required Verify that approvals match the correct patient, procedure, CPT code, facility, and date of service Document authorization numbers, effective and expiration dates, case/reference numbers, and payer requirements Confirm authorization status before scheduled diagnostic testing Assist with authorization denials, reconsiderations, and appeals when appropriate Maintain accurate documentation in eClinicalWorks and payer systems Communicate authorization-related delays or issues to staff and patients when necessary

Qualifications Required:

Previous experience with medical insurance verification and prior authorizations Strong knowledge of insurance eligibility, benefits, and authorization processes Ability to manage multiple pending cases and deadlines Strong computer, documentation, communication, and follow-up skills Excellent attention to detail

Strongly Preferred:

Previous experience obtaining diagnostic imaging prior authorizations, particularly CT and MRI Experience with Medicare Advantage, commercial insurance, and managed-care plans Familiarity with payer portals and utilization-management vendors Experience with medical-necessity requirements and peer-to-peer processes Working knowledge of CPT and ICD-10 coding Experience with eClinicalWorks What Makes Someone Successful in This Position Accuracy and follow-through are critical. Before diagnostic testing is performed, the authorization must be verified to ensure the procedure being performed matches what the insurance company approved. We are looking for someone who takes ownership of pending authorizations, follows cases through completion, communicates problems promptly, and works to resolve issues before they affect a patient's scheduled care.

Position Details Job Type:

Full-time Schedule:

Monday through Friday; some weekend hours may be required

Location:

Port Richey, Florida Department:

Diagnostic Imaging Pay:

Starting at $21/hour; higher starting rate available based on relevant CT/MRI authorization experience Gulf Coast Medical Center is an established multispecialty medical practice serving the local community for more than 45 years. We offer a professional, team-oriented outpatient environment focused on patient care and efficient operations. Please submit a current resume detailing your insurance verification and prior authorization experience. Candidates with CT/MRI authorization experience are encouraged to highlight that experience when applying.

Pay:

From $21.00 per hour Expected hours: 40.0 per week

Benefits:

401(k) Dental insurance Disability insurance Employee discount Health insurance Life insurance Paid time off Vision insurance

Experience:

prior-authorization: 1 year (Required) CT/MRI authorization: 1 year (Preferred)

Work Location:

In person