Insurance Denials Specialist II

RAYUS Radiology - Saint Louis Park, MN

Full-time - Entry Level

Remote - Saint Louis Park, MN

About the position

The Insurance Denials Specialist II at RAYUS Radiology is responsible for investigating and resolving denied or unpaid claims to expedite medical billing and collections. This role requires effective communication with various stakeholders, including patients and insurance carriers, to ensure timely follow-up and resolution of accounts receivable. The position is fully remote and operates within a team environment, emphasizing collaboration and dedication to patient care.

Responsibilities

• Investigate and determine reasons for denied or unpaid claims.
• Review denied claim information using payer's explanation of benefits and make outbound calls to payer's provider relations department.
• Obtain appropriate information or documentation for claim re-submission per insurance guidelines.
• Communicate with patients, insurance carriers, co-workers, and referral sources in a timely manner.
• Document all communications in the billing system.
• Contribute to reducing days-sales-outstanding (DSO) and increasing monthly gross collections.
• Prioritize workload focusing on priority tasks to enhance bottom line results.
• Recognize and communicate trends in workflow to departmental leaders.
• Meet or exceed RCM Quality Assurance standards.
• Ensure timely follow-up and completion of daily tasks.

Requirements

• 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 typing.

Nice-to-haves

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

Benefits

• DailyPay - Work today, get paid today!