Prior Authorization Specialist

Insurance Specialist

RAYUS Radiology is looking for an Insurance 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 be responsible 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 position is full-time working M-F 9:00a-5:30p and 1 Saturday per month as OT (8a-12p). This role will require 6 months of onsite training at our Indianapolis, Indiana East location.

Essential Duties and Responsibilities:

• 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

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

Completes Other Duties and Projects as Assigned

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:

• 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.