Insurance Denials Specialist II

About the position

The Insurance Denials Specialist II at RAYUS Radiology is responsible for investigating denied or unpaid claims and taking necessary actions to expedite the medical billing and collections process. This full-time remote position requires effective communication with various stakeholders, including patients and insurance carriers, to ensure timely resolution of claims and enhance the overall financial performance of the organization.

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 other stakeholders 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!
• Remote work opportunity
• Equal opportunity employer policies