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Insurance Specialist II

3 months ago

St Louis Park, United States RAYUS Radiology Full time
Job Summary

RAYUS Radiology is looking for an Insurance Specialist II to join our team As an Insurance Specialist II, you'll provideexpertise 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. In addition, serves as a resource to the team and other departments. This is a part-time position (typically working 32 hours/week) Monday, Wednesday, Thursday, Friday from 9:00am-3:00pm and Tuesdays from 9:00am-5:00pm CST; includes Saturday rotation.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(60%) 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%) Team Support
  • Acts as a resource to the team and other departments
  • Assists in the training and onboarding of new hires, when applicable
  • Supports process improvement initiatives to improve front office scheduling and registration accuracy and improve patient experience
  • Assists with special projects as assigned
(5%) Completes other duties as assigned

Requirements

Required:
  • High school diploma or equivalent
  • 1+ years previous health care experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage with demonstrated ability to serve as a resource to others and recognize process improvement opportunities
  • 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 Radiologyis an EO Employer/Vets/Disabled.

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