Prior Authorization Specialist

RAYUS Radiology•Saint Louis Park, MN

13h•Onsite

About The Position

RAYUS Radiology is looking for an Insurance Specialist to join their team. They are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. As an Insurance Specialist, you will be responsible for providing expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. You will also develop and maintain positive relationships with referring physicians and patients. This position is full-time working M-F 9:00a-5:30p and 1 Saturday per month as OT (8a-12p). This role will require 6 months of onsite training at their Indianapolis, Indiana East location.

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
Receives pre-authorization from patients and/or insurance companies and documents
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