Insurance Denials Specialist II for No Prior Authorizations

RAYUS Radiology•St. Louis Park, MN

12d•$21 - $30

About The Position

RAYUS Radiology is looking for an Insurance Denials 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 Denials Specialist you will investigate and determine the reason for a denied or unpaid claim, and take necessary steps to expedite the medical billing and collections of the accounts receivable. At CDI our passion for our patients, customers and purpose requires teamwork and dedication from all of our associates. Working in a team environment, you'll communicate with patients, insurance carriers, co-workers, centers, markets, referral sources and attorneys in a timely, effective manner. This position is full-time, working Monday-Friday 8-4:30.

Requirements

High School diploma or equivalent
2+ years' experience in a medical billing department, prior authorization department or payer claim processing department, or 9+ months experience as Insurance Denials Specialist within the organization
Proficiency with Microsoft Excel, PowerPoint, Word, and Outlook
Proficient with using computer systems and typing

Nice To Haves

Graduate of an accredited medical billing program
Bachelor's degree strongly preferred
Knowledge of ICD-10, CPT and HCPCS codes

Responsibilities

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
As backup for customer service team, communicates and responds to customer inquiries as needed