Insurance Denials Specialist III

RAYUS now offers DailyPay! Work today, get paid today!

The pay range for this position is $22.40 - $31.87 based on direct and relevant experience.

RAYUS Radiology is looking for a Insurance Denials Specialist III to join our team. We are challenging the status quo by shining the 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 III you will be responsible for researching denied claims to determine the reason for a denied or unpaid claim and take necessary steps to expedite the medical billing and collections of the accounts receivable. 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 is a 100% remote full-time position working 40 hours per week working corporate hours.

This is a full-time remote position working 40 hours per week. Shifts are from 8:00am-4:30pm.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(85%) 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%) Staff Support

Assists in the mentoring and training of new Insurance Denials Specialists

Recommends and assists in implementing new approaches and ideas for improvement in processes and workflows

Serves as a resource for Insurance Denials Specialists

As assigned, acts as department go-to resource for team and others in Lead or Manager’s absence

(10%) Performs other duties as assigned

As backup for customer service team, communicates and responds to customer inquiries as needed