Insurance Specialist

RAYUS Radiology; Boynton Beach (FL); Hybrid; USD 48,000 - 62,000; Full time

Job summary

RAYUS Radiology is seeking an Insurance Specialist to join our team in a full-time capacity. You will verify insurance information, obtain pre-certifications, and communicate with patients and providers to ensure coverage for radiology services.

The role emphasizes pre-certification and authorization, coordination with referring physicians, and maintaining compliant, accurate records while delivering excellent service.

Qualifications

• 1 year of healthcare experience with insurance pre-certification/authorization.
• Experience with managed care and physician office scheduling.
• Proficient with Microsoft Office and typing.
• High school diploma or equivalent (required).

Responsibilities

• Accountable for insurance pre-certification and service authorization.
• Call insurers and patients to verify and obtain needed information.
• Document pre-authorizations and maintain HIPAA-compliant communication.
• Enter data accurately into the system and support front desk operations.

Skills

HIPAA guidelines

Phone calls

Organizational skills

Customer service

Education

High School Diploma

Tools

Microsoft Office Suite

Job description

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

RAYUS Radiology is looking for anInsurance Specialist 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, you will beresponsible for providing 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.

This is a Full Time Position Scheduled Monday-Friday 9:00am-5:30pm.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(65%) Insurance Administration

• Prioritize workload to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority
• Determine if patient's insurance is a part of the provider network
• Make outgoing calls to insurance companies for pre-certification or any authorization
• Receives pre-authorization from patients and/or insurance companies and documents
• Contact patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed
• Accurately enter a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system
• Maintain positive interactions with referring offices, patients and staff
• Backup front desk reception and scheduling area as needed

(30%) Price Quotes

• Complete payor-related information, i.e., payor, payor class, date of appointment
• Obtain all workers compensation approvals from insurance companies prior to scheduled exam
• Obtain patient signs and symptoms in order to support medical necessity

(5%) Completes Other Duties and Projects as Assigned

Remote Position

No

Status

Full-time

Requirements

Required:

• High School Diploma, or equivalent
• One (1) year of healthcare experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
• Prior experience with managed care and physician office scheduling
• Microsoft Office Suite Experience
• Proficient with using computer systems and typing

Preferred:

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 .

DailyPay implementation is contingent upon initial set-up period.

EEO is the Law