Insurance denial specialist III

RAYUS now offers Daily Pay! Work today, get paid today!

The pay range for this position is $22.40 - $31.87 based on direct and relevant experience.

RAYUS Radiology is looking for an Insurance Denials Specialist to join our team. We are challenging the status quo by shining the 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 Denials Specialist you will investigate and determine the reason for a denied or unpaid claim, and take necessary steps to expedite the medical billing and collections of the accounts receivable.

At CDI our passion for our patients, customers and purpose requires teamwork and dedication from all of our associates. Working in a team environment, you'll communicate with patients, insurance carriers, co‑workers, centers, markets, referral sources and attorneys in a timely, effective manner.

This is a full‑time fully remote position working 40 hours per week; shifts are 8:00 am – 5:00 pm.

(85%) Insurance Denial Follow‑up

• Accurately and efficiently review 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
• Review and obtain appropriate information or documentation from claim re‑submission for all denied services, per insurance guidelines and requirements
• Communicate 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
• Document all communications with coworkers, patients, and payer sources in the billing system
• Contribute to the steady reduction of the days‑sales‑outstanding (DSO), increase monthly gross collections and increase percentage of collections
• Prioritize workload, concentrating on "priority" work that enhances bottom‑line results and achievement of the most important objectives
• Contribute to a team environment
• Recognize and communicate trends in workflow to departmental leaders
• Meet or exceed RCM Quality Assurance standards
• Ensure timely follow‑up and completion of all daily tasks and responsibilities

• Assist in the mentoring and training of new Insurance Denials Specialists
• Recommend and assist in implementing new approaches and ideas for improvement in processes and workflows
• Serve as a resource for Insurance Denials Specialists
• As assigned, act as department go‑to resource for team and others in Lead or Manager's absence

• As backup for customer service team, communicate and respond to customer inquiries as needed

• High School diploma or equivalent
• 4+ years' experience in a medical billing department, prior authorization department or payer claim processing department, or 2+ years' experience as Insurance Denials Specialist within the organization
• Intermediate proficiency with Microsoft Excel, PowerPoint, Word, and Outlook
• Proficient with using computer systems and typing

• 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:

* Daily Pay implementation is contingent upon initial set‑up period.