Insurance Denials Specialist III

RAYUS Radiology•St. Louis Park, MN

1d•$22 - $32•Remote

About The Position

RAYUS Radiology is looking for an Insurance Denials Specialist III to join their team. The company is focused on making radiology a critical first step in diagnosis and proper treatment. As an Insurance Denials Specialist III, the individual will be responsible for researching denied claims to determine the reason for denial or non-payment and taking necessary steps to expedite medical billing and collections of accounts receivable. This role operates in a team environment, requiring communication with patients, insurance carriers, co-workers, centers, markets, referral sources, and attorneys in a timely and effective manner. This is a 100% remote, full-time position working 40 hours per week during corporate hours.

Requirements

High School diploma or equivalent
4 years’ experience in a medical billing department, prior authorization department or payer claim processing department, or 2+ years’ experience as Insurance Denials Specialist within the organization
Intermediate 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.
Assists in the mentoring and training of new Insurance Denials Specialists.
Recommends and assists in implementing new approaches and ideas for improvement in processes and workflows.
Serves as a resource for Insurance Denials Specialists.
As assigned, acts as department go-to resource for team and others in Lead or Manager’s absence.
As backup for customer service team, communicates and responds to customer inquiries as needed.