Insurance Specialist

4 weeks ago

St Louis Park, United States RAYUS Radiology Full time

RAYUS Radiology, formerly Center for Diagnostic Imaging, is looking for an Insurance Specialist to join our team. As an Insurance Specialist, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. Develops and maintains positive relationships with referring physicians and patients. This is a fulltime position working Monday-Friday from 10:00am-6:30pm CST; includes weekend rotation.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(65%) Insurance Administration

  • Prioritizes work load to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority
  • Determines if patient's insurance is a part of the provider network
  • Makes outgoing calls to insurance companies for pre-certification or any authorization
  • Receives pre-authorization from patients and/or insurance companies and documents
  • Contacts patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed
  • Accurately enters a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system
  • Maintains positive interactions with referring offices, patients and staff
  • Backs up front desk reception and scheduling area as needed

(30%) Price Quotes

  • Completes payor-related information i.e., payor, payor class, date of appointment
  • Obtains all workers compensation approvals from insurance companies prior to scheduled exam
  • Obtains signs and symptoms in order to support medical necessity

(5%) Completes other duties as assigned


Required:

  • High school diploma or equivalent
  • 1-2 years previous health care 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

Preferred:

  • Bilingual

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. #LI-JH1
Rayus is an equal opportunity employer; applicants are considered without discrimination with regard to race, color, religion, sex, national origin, age, disability, veteran status or other statuses protected by state, local or other applicable laws. This policy extends to all aspects of employment, including recruitment and hiring.

Rayus and its associates have an employment relationship, which is known as employment-at-will. This means that either Rayus or an associate has the right to terminate the employment relationship at any time, for any reason with or without cause or prior notice.

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