Prior Authorization Manager (Remote)
Prior Authorization Manager – Radiology (Full-Time) Company: StreamlineMD Location: 100% Remote About StreamlineMD StreamlineMD provides specialized revenue cycle management and EHR solutions for radiology and interventional radiology practices nationwide. Our mission is to help physicians deliver exceptional patient care while we optimize their financial performance. We are expanding our Prior Authorization operations and seeking a strong leader who understands the unique demands of radiology pre-certification and front-end revenue protection. Position Summary The Prior Authorization Manager leads StreamlineMD’s authorization team responsible for securing timely and accurate pre-certifications for MRI, CT, PET, ultrasound, and interventional radiology procedures. This role ensures operational excellence, reduces avoidable denials, and supports a smooth scheduling and billing workflow for our physician clients.
Key Responsibilities
- Lead, coach, and develop a team of Prior Authorization Specialists.
- Oversee the complete authorization workflow for radiology and IR procedures.
- Ensure timely eligibility checks, medical necessity review, and payer submissions.
- Serve as the escalation point for complex, high-cost, or urgent cases.
- Maintain expert knowledge of payer rules, radiology CPT/HCPCS codes, and pre-cert requirements.
- Monitor denial trends and implement proactive prevention strategies.
- Collaborate with scheduling, coding, billing, and client service teams to support seamless operations.
- Track KPIs (turnaround time, approval rates, productivity) and provide reporting to leadership.
- Maintain SOPs and ensure compliance with payer and regulatory requirements.
Qualifications
- 3–5+ years of experience in prior authorization, medical billing, or radiology RCM.
- 1–2+ years of supervisory or team lead experience preferred.
- Strong understanding of radiology CPT/HCPCS codes and payer medical necessity guidelines.
- Experience with payer portals (AIM, Evicore, etc.) and RCM/EHR systems.
- Excellent communication, problem-solving, and organizational skills. Preferred
- Experience in a radiology practice, imaging center, or radiology billing company.
- Certifications such as CRCR, CPC, or CPAR.
- Experience managing remote or multi-site teams. Why Join StreamlineMD
- Competitive compensation and benefits
- Opportunity to grow within a specialized, physician-focused RCM organization
- Collaborative culture with supportive leadership
- Meaningful work that directly impacts patient access and client revenue performance How to Apply Apply directly through Indeed. EOS/ MANAGEMENT OPERATING SYSTEM EOS, the Entrepreneurial Operating System®, is a complete set of simple concepts and practical tools that has helped thousands of entrepreneurs around the world get what they want from their businesses. Implementing EOS will help you and your leadership team get better at three things: VISION Get everyone in your organization 100% on the same page with where you’re going and how you plan to get there. TRACTION® Instill focus, discipline, and accountability throughout the company so that everyone executes on that vision – every day. HEALTHY Help your leaders become a more cohesive, functional, healthy leadership team. REMOTE WORK REQUIREMENTS Residential broadband internet access - Cable service or fiber optic is the preferred solution. The minimum recommended Internet download speed is 10 Mbps and upload is 1 Mbps (Megabits per seconds). DSL is acceptable. Cellular Hot Spots, Satellite and dial up are not acceptable primary access solutions. Suitable in-home workspace Job Type: Full-time Pay: $60,000.00 - $70,000.00 per year Benefits:
- Parental leave
- Referral program Experience:
- Medical billing: 5 years (Preferred)
- Insurance Prior Authorization: 5 years (Required) Work Location: Remote
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