[Hiring] Insurance Denials Specialist @RAYUS Radiology

Role Description

RAYUS Radiology is looking for an Insurance Denials Specialist I to join our team. As an Insurance Denials Specialist, you will:

• Investigate and determine the reason for a denied or unpaid claim.
• Take necessary steps to expedite the medical billing and collections of the accounts receivable.
• Work in a team environment, communicating with patients, insurance carriers, co-workers, and referral sources in a timely, effective manner.

This position is full-time, 100% remote, working Monday-Friday 8:00 AM - 4:30 PM.

Essential Duties and Responsibilities:

• (95%) 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 a specific denial type or payer.
  • 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, and referral sources 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.
  • Collaborates with supervisor on prioritization of work to enhance bottom line results and achievement of the most important objectives.
  • Contributes to a team environment.
  • Makes and organizes notes to track workflow and identify trends to communicate to departmental leaders.
  • Meets or exceeds RCM Quality Assurance standards.
  • Ensures timely follow-up and completion of all daily tasks and responsibilities.
• (5%) Performs other duties as assigned.

Qualifications

• High School diploma or equivalent.
• 1+ year experience in a medical billing department, provider front office, the Company's imaging center operations, prior authorization department, or payer claim processing department.
• Proficiency with Microsoft Excel, PowerPoint, Word, and Outlook.
• Proficient with using computer systems and typing.

Requirements

• Graduate of an accredited medical billing program (preferred).
• Bachelor's degree strongly preferred.
• Knowledge of ICD-10, CPT, and HCPCS codes (preferred).

Benefits

• Medical, dental, and vision insurance.
• 401k with company match.
• Life and disability insurance.
• Tuition reimbursement.
• Adoption assistance.
• Pet insurance.
• PTO and holiday pay.
• Many more benefits (based on eligibility).