Insurance Specialist

RAYUS Radiology•Scarborough, ME

1d•Onsite

About The Position

RAYUS Radiology is looking for an Insurance Specialist to join their team. This role involves providing expertise in insurance pre-certification and authorization of services by contacting insurance companies and patients to verify insurance information. The specialist will also develop and maintain positive relationships with referring physicians and patients.

Requirements

High School Diploma, or equivalent
One (1) year of healthcare experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
Prior experience with managed care and physician office scheduling
Microsoft Office Suite Experience
Proficient with using computer systems and typing

Nice To Haves

Bilingual

Responsibilities

Prioritize workload to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority.
Determine if patient's insurance is a part of the provider network.
Make outgoing calls to insurance companies for pre-certification or any authorization.
Receive pre-authorization from patients and/or insurance companies and document.
Contact patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed.
Accurately enter a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system.
Maintain positive interactions with referring offices, patients and staff.
Backup front desk reception and scheduling area as needed.
Complete payor-related information, i.e., payor, payor class, date of appointment.
Obtain all workers compensation approvals from insurance companies prior to scheduled exam.
Obtain patient signs and symptoms in order to support medical necessity.
Completes Other Duties and Projects as Assigned.