Insurance Denials Specialist II

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The pay range for this position is $19.44 - $28.07 based on direct and relevant experience.

RAYUS Radiology is looking for a Insurance Denials Specialist I 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 a Insurance Denials Specialist I, 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, and referral sources in a timely, effective manner. This is a full-time position working 40 hours per week, from 8am to 5pm.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Creates a positive experience for every customer, every day by believing in and practicing The Experience

(95%) Insurance Denial Follow-up

• 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 a specific denial type or payer
• 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, and referral sources 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
• Collaborates with supervisor on prioritization of work to enhance bottom line results and achievement of the most important objectives
• Contributes to a team environment
• Makes and organizes notes to track workflow and identify trends to communicate to departmental leaders
• Meets or exceeds RCM Quality Assurance standards
• Ensures timely follow-up and completion of all daily tasks and responsibilities

(5%) Performs other duties as assigned

Required:

• High School diploma or equivalent
• 1+ year experience in a medical billing department, provider front office, the Company's imaging center operations, prior authorization department or payer claim processing department
• Proficiency with Microsoft Excel, PowerPoint, Word, and Outlook
• Proficient with using computer systems and typing

Preferred:

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

RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible.

We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services!

RAYUS Radiology is an EO Employer/Vets/Disabled.