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Insurance Specialist

RAYUS Radiology
United States, Florida, Boynton Beach
Apr 06, 2025
RAYUS now offers DailyPay! Work today, get paid today! As an Insurance Specialist, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information and initiate authorizations. You will also develop and maintain positive relationships with referring physicians and patients. This position is full-time, offering a 5 day (M-F)/8 hour shift option or 4 day/10 hour shift, which includes Saturday and/or Sunday. ESSENTIAL DUTIES AND RESPONSIBILITIES: (65%) Insurance Administration Prioritizes workload to ensure all patients are authorized prior to their exam Determines if patient's insurance is a part of the provider network Makes outgoing calls to insurance companies for pre-certification or any authorization Receives pre-authorization from patients and/or insurance companies and documents Contacts patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed Accurately enters a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system Maintains positive interactions with referring offices, patients and staff Obtains signs and symptoms in order to support medical necessity Obtains all workers compensation approvals from insurance companies prior to scheduled exam Completes payor-related information i.e., payor, payor class, date of appointment (30%) Price Quotes Verifies insurance eligibility and benefits Verifies copay, coinsurance, and deductible information Calculate patients expected financial responsibility Notify patients of expected financial responsibility (5%) Completes other duties as assigned Required: High school diploma or equivalent Prior experience with managed care and physician office scheduling Proficient with using computer systems and typing Knowledge of medical terminology Knowledge of CPT and ICD-10 coding Ability to read and interpret physician notes, diagnosis and other clinical documentation Ability to multitask Ability to focus and maintain direction in the tasks at hand under pressure Preferred: 1-2 years previous health care experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage Bilingual 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. #LI-SR1