Insurance Specialist

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RAYUS Radiology 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.

This is a full-time position working 40 hours per week. Shifts are from 9:00am-5:30pm or 9:30am-6:00pm.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(65%) 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%) Completes other duties as assigned

Required:

• High school diploma or equivalent
• 1-2 years previous health care experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
• Prior experience with managed care and physician office scheduling
• Microsoft Office Suite Experience
• Proficient with using computer systems and typing

Preferred:

• Bilingual