Insurance Claims Specialist

6 days ago


Saint Cloud, Minnesota, United States Rayus Radiology Full time

Job Summary

RAYUS Radiology is seeking an Insurance Specialist to provide expertise in insurance pre-certification and authorization of services. The successful candidate will have excellent communication skills and be able to develop positive relationships with referring physicians and patients.

Key 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
  • 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

Additional Responsibilities

  • 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

Requirements

The ideal candidate will have excellent communication skills, be able to work in a fast-paced environment and have a strong attention to detail.


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