Insurance Denials Specialist for Coding Denial Management

RAYUS Radiology•St. Louis Park, MN

1d•$21 - $30•Remote

About The Position

RAYUS Radiology is seeking an Insurance Denials Specialist II to join their team. This role involves investigating denied or unpaid insurance claims, determining the reasons for denial, and taking necessary actions to expedite the medical billing and collections process for accounts receivable. The position operates in a team environment, requiring effective communication with patients, insurance carriers, colleagues, centers, markets, referral sources, and attorneys. This is a full-time, remote position with working hours from Monday to Friday, 8:00 am to 4:30 pm.

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.
Performs other duties as assigned.