Skip to Main Content

Job Title


Prior Authorization Specialist - Lead Radiology


Company : Taglynk


Location : Bengaluru, Karnataka


Created : 2025-07-12


Job Type : Full Time


Job Description

We are looking for a dedicated and detail-oriented Prior Authorization Associate with at least 4 year of radiology-specific prior authorization experience, including hands-on use of CoverMyMeds. The ideal candidate will be responsible for managing and securing timely prior authorizations for radiology services such as MRI, CT, PET, and ultrasound to support smooth and uninterrupted patient care. Responsibilities: Review and process prior authorization requests for radiology procedures in accordance with payer-specific guidelines. Utilize CoverMyMeds and other payer portals to submit and track authorizations. Collaborate with referring providers, radiology departments, and insurance representatives to collect and verify required documentation. Communicate with insurance carriers and radiology benefit managers (RBMs) to obtain approvals or resolve denials. Accurately document all communications, decisions, and outcomes in the EHR or scheduling systems. Maintain up-to-date knowledge of payer and RBM requirements, including CPT codes specific to radiology. Support scheduling and billing teams with timely updates on authorization status to avoid delays or denials in claims. Escalate complex cases to supervisors or clinical staff when needed. Requirements: High school diploma or GED required; Associate degree or relevant healthcare certification preferred. Minimum 1 year of experience in prior authorization, with a strong focus on radiology services. Proficiency with CoverMyMeds and other pre-certification portals (e. g., Availity, AIM, Evicore). Strong knowledge of medical terminology, insurance verification processes, and radiology CPT codes. Excellent verbal and written communication skills. Ability to multitask and manage time effectively in a fast-paced environment. Familiarity with electronic health record (EHR) systems. Experience working with Medicare, Medicaid, and commercial payers. Prior experience in a radiology department, imaging center, or related clinical setting. Bilingual communication skills are a plus.