Insurance Denials Specialist II for Coding Denial Management

RAYUS Radiology
vision insurance, tuition reimbursement, 401(k)
United States, Minnesota, St. Louis Park
5775 Wayzata Boulevard (Show on map)
Apr 11, 2025
RAYUS now offers DailyPay! Work today, get paid today! The pay range for this position is $20.70 -$29.93 based on direct and relevant experience. 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. Develops and maintains positive relationships with referring physicians and patients. In addition, serves as a resource to the team and other departments. This is a full-time position working 40 hours per week. Shifts are Monday-Friday from 8:00 AM - 4:30 PM. Essential Duties & Responsibilities: (90%) 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%) Performs other duties as assigned Required: High School diploma or equivalent Certified Coder through AAPC, AHIMA, or another recognized certification 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 Preferred: Graduate of an accredited medical billing program Bachelor's degree strongly preferred Knowledge of ICD-10, CPT and HCPCS codes RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible. We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services! RAYUS Radiology is an EO Employer/Vets/Disabled. We offer benefits (based on eligibility) including medical, dental and vision insurance, 401k with company match, life and disability insurance, tuition reimbursement, adoption assistance, pet insurance, PTO and holiday pay and many more! Visit our career page to see them all www.rayusradiology.com/careers.