Insurance Denials Specialist II for no prior authorizations
2 weeks ago
Job Summary
RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for an Insurance Denials Specialist II 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 an Insurance Denials Specialist II, 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, centers, markets, referral sources and attorneys in a timely, effective manner. This position is full-time working Monday - Friday 8:00am - 4:30pm, and is 100% remote.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
(90%) 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 multiple denial types, payers, and/or states 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, centers, markets, referral sources and attorneys 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 Prioritizes work load, concentrating on “priority” work which will enhance bottom line results and achievement of the most important objectives Contributes to a team environment Recognizes and communicates trends in workflow to departmental leaders Meets or exceeds RCM Quality Assurance standards Ensures timely follow-up and completion of all daily tasks and responsibilities(10%) Performs other duties as assigned
Requirements
Required:
High School diploma or equivalent 2+ years’ experience in a medical billing department, prior authorization department or payer claim processing department, or 9+ months experience as Insurance Denials Specialist within the organization Proficiency with Microsoft Excel, PowerPoint, Word, and Outlook Proficient with using computer systems and typingPreferred:
Graduate of an accredited medical billing program Bachelor’s degree strongly preferred Knowledge of ICD-10, CPT and HCPCS codesRAYUS is committed to delivering clinical excellence in communities across the , 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.
-
St. Louis Park, United States RAYUS Radiology Full timeRAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for an Insurance Denials Specialist II 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 an Insurance Denials Specialist II,...
-
Valley Park, Missouri, United States RAYUS Radiology Full timeRAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for an Insurance Denials Specialist II 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 an Insurance Denials Specialist II,...
-
Insurance Specialist II
2 weeks ago
St Louis Park, United States CDI Corporation Full timeRAYUS Radiology is looking for an Insurance Specialist II to join our team! As an Insurance Specialist II, you'll 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. In...
-
Insurance Specialist II
2 weeks ago
St Louis Park, United States RAYUS Radiology Full timeJob 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...
-
Authorization Specialist
3 weeks ago
St Louis Park, United States Park Nicollet Health Services Full timePark Nicollet is looking to hire an Authorization Specialist to join our team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day. Position Summary: The Authorization Specialist is responsible for creating hospital encounters for surgical services throughout Park...
-
Prior Authorization
4 weeks ago
Baldwin Park, United States Polaris Pharmacy Services Full time**PRIOR AUTHORIZATION SPECIALIST** **OVERVIEW** The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior Authorization Specialist must be responsive and courteous when...
-
Prior Authorization
2 weeks ago
Baldwin Park, United States Polaris Pharmacy Services Full time**PRIOR AUTHORIZATION SPECIALIST** **OVERVIEW** The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior Authorization Specialist must be responsive and courteous when...
-
Prior Authorization Specialist
1 week ago
Clifton Park, United States The US Oncology Network Full timeOverview: Employment Type : Full Time **Remote Position** Benefits : M/D/V, Life Ins., 401(k), PTO, Paid Holidays Clifton Park, NY Pay Range: $20-$24 hourly **JOB SCOPE**:Under general supervision, reviews chemotherapy regimens in accordance to reimbursement guidelines. Obtains necessary pre-certifications and exceptions to ensure no delay in...
-
Infusion Prior Authorization Specialist
2 weeks ago
St Louis, United States BJC HealthCare Full timeAdditional Information About the Role Come and join the BJC Family! * Remote Position* Monday - Friday / no weekends or Holidays* 8-4:30 pm set schedule* Looking for someone with Oncology experience* Daily Pay $$$ Overview Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's...
-
Prior Authorization Specialist
3 weeks ago
Overland Park, Kansas, United States Randstad USA Full timeDo you currently have experience processing pre-authorizations for the healthcare industry? Would you say you have experience providing world class customer service and managing a high call volume? Do you know medical terminology and can track and process insurance claims through the entire process? Are you looking for a role where you can work independenly?...
-
Prior Authorization Specialist
1 month ago
Overland Park, Kansas, United States Randstad USA Full timeDo you currently have experience processing pre-authorizations for the healthcare industry? Would you say you have experience providing world class customer service and managing a high call volume? Do you know medical terminology and can track and process insurance claims through the entire process? Are you looking for a role where you can work independenly?...
-
Insurance Specialist
3 weeks ago
St Louis Park, United States CDI Corporation Full timeRAYUS 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...
-
Healthcare Customer Service Representative
3 weeks ago
St Louis Park, United States Center For Diagnostic Imaging Full timeRAYUS Radiology, formerly Center for Diagnostic Imaging, is looking for a Customer Service Specialist to join our team. As a Customer Service Specialist in our Revenue Cycle Management (RCM) group, you'll assist patients, clinics, referring doctors, attorneys, and insurance companies with medical billing questions. You'll answer telephone calls, respond to...
-
Insurance Specialist
3 weeks ago
St Louis Park, United States RAYUS Radiology Full timeJob Summary RAYUS Radiology, formerly Center for Diagnostic Imaging, is looking for an Insurance Specialistto 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...
-
St Louis, United States Mercy Full timeWe're a Little Different Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine...
-
Insurance Specialist II
1 week ago
Valley Park, Missouri, United States RAYUS Radiology Full timeJob Summary RAYUS Radiology is seeking an experienced Insurance Specialist II to join their team. As an Insurance Specialist II, you will play a key role in handling insurance pre-certification and service authorization by communicating with insurance companies and patients to verify insurance details. The position also involves building and maintaining...
-
St Louis, United States Mercy Full timeWe're a Little DifferentOur mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine...
-
Medical Claim and Denial Specialist
4 weeks ago
St Paul, United States Ultimate Staffing Full timeWe have an opening for a Medical Claim and Denial Specialist! Job Duties/Description: Review claims for accuracy prior to submission. Ensure required supporting documentation is on file before claim submission. Identify and resolve claim rejections and denials. Maintain a working knowledge of the payer's appeals process. Mark accounts for no bill in case...
-
Medical Claim and Denial Specialist
3 weeks ago
St Paul, United States Ultimate Staffing Full timeWe have an opening for a Medical Claim and Denial Specialist! Job Duties/Description: Review claims for accuracy prior to submission. Ensure required supporting documentation is on file before claim submission. Identify and resolve claim rejections and denials. Maintain a working knowledge of the payer's appeals process. Mark accounts for no bill in case...
-
Prior Authorization/Referral Coordinator
1 month ago
Saint Louis, United States Affinia Healthcare Full timeJob DescriptionJob DescriptionPOSITION SUMMARY: Responsible for collecting all the necessary documentation, contacting the client for additional information and completion of the required prior authorization order. Complete, timely and accurate identification and submission of prior and retro authorization requests to the payors. Interacts with patients,...