Insurance Specialist II

RAYUS Radiology is looking for an Insurance 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 Specialist II, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information and also serves as a resource to the team and other departments. This role develops and maintains positive relationships with referring physicians and patients. This is a full-time position working 40 hours per week. Shifts are from 9:00am-6:30pm. 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(60%) Insurance Administration

• 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
• Make outgoing calls to insurance companies for pre-certification or any authorization
• Receives pre-authorization from patients and/or insurance companies and documents
• Contact patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed
• Accurately enter a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system
• Maintain positive interactions with referring offices, patients and staff
• Backup front desk reception and scheduling area as needed

(30%) Price Quotes

• Complete payor-related information, i.e., payor, payor class, date of appointment
• Obtain all workers compensation approvals from insurance companies prior to scheduled exam
• Obtain patient signs and symptoms in order to support medical necessity

(5%) Team Support

• Function as a resource to the insurance team and other departments
• Support process improvement initiatives to improve front office scheduling and registration accuracy and improve patient experience
• Assist with the training and onboarding of new hire team members, when applicable
• Assist with special projects as assigned

(5%) Completes Other Duties and Projects as Assigned

• High School Diploma, or equivalent
• Two (2) years' healthcare experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
• One (1) year of experience working with managed care and physician office scheduling
• Demonstrated ability to serve as a resource to others and recognize process improvement opportunities
• Intermediate experience using Microsoft Office Suite products
• Proficient with using computer systems and typing

Preferred:

• Bilingual