Insurance Denials Specialist II for Coding Denial Management

Job Summary

RAYUS now offers DailyPay! Work today, get paid today!

The pay range for this position is $20.70 -$29.93 based on direct and relevant experience. 

RAYUS Radiology is looking for an Insurance Specialist II to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As an Insurance Specialist II, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. Develops and maintains positive relationships with referring physicians and patients. In addition, serves as a resource to the team and other departments. This is a full-time position working 40 hours per week. Shifts are Monday-Friday from 8:00 AM - 4:30 PM.

Essential Duties & Responsibilities:

(90%) Insurance Denial Follow-up

• Accurately and efficiently reviews denied claim information using the payer’s explanation of benefits, website, and by making outbound phone calls to the payer’s provider relations department for multiple denial types, payers, and/or states
• Reviews and obtains appropriate information or documentation from claim re-submission for all denied services, per insurance guidelines and requirements
• Communicates with patients, insurance carriers, co-workers, centers, markets, referral sources and attorneys in a timely, effective manner to expedite the billing and collection of accounts receivable
• Documents all communications with coworkers, patients, and payer sources in the billing system
• Contributes to the steady reduction of the days-sales-outstanding (DSO), increases monthly gross collections and increases percentage of collections
• Prioritizes work load, concentrating on “priority” work which will enhance bottom line results and achievement of the most important objectives
• Contributes to a team environment
• Recognizes and communicates trends in workflow to departmental leaders
• Meets or exceeds RCM Quality Assurance standards
• Ensures timely follow-up and completion of all daily tasks and responsibilities

(10%) Performs other duties as assigned