Prior Authorization Specialist

About the role

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.

Schedule

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

• Insurance Administration (65%):
  • 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 (30%):
  • 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 (5%)

Requirements

• 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 qualifications

• Bilingual

Benefits

• Medical, dental and vision insurance
• 401k with company match
• Life and disability insurance
• Tuition reimbursement
• Adoption assistance
• Pet insurance
• PTO and holiday pay
• DailyPay (work today, get paid today — implementation is contingent upon initial set-up period)