Insurance Claims Specialist

4 weeks ago


Boynton Beach, Florida, United States RAYUS Radiology Full time

Insurance Specialist Role at RAYUS Radiology

RAYUS Radiology is seeking a skilled Insurance Specialist to join our team. As an Insurance Specialist, you will play a crucial role in ensuring seamless insurance pre-certification and authorization processes for our patients.

Key Responsibilities:

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

Additional Responsibilities:

  • Verifies insurance eligibility and benefits
  • Calculate patients expected financial responsibility
  • Notify patients of expected financial responsibility

About RAYUS Radiology:

RAYUS Radiology is a leading provider of diagnostic imaging services. We are committed to delivering exceptional patient care and experiences.



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