Lead Insurance Denials Specialist For Prior Authorizations

RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for a Lead Insurance Denials 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 a Lead Insurance Denials Specialist, you will coordinate communications regarding billing information with patients, carriers, co-workers and attorneys to ensure timely collections of accounts receivables and provides direction and training to account representative team. Position is full-time, working remotely Monday

• Friday 8:00am

• 4:30pm

ESSENTIAL DUTIES AND RESPONBILITIES:

(65%) Accounts Receivable Collection & Leadership

• Communicates with patients, carriers, co-workers, center staff, attorneys, and other contracted entities and responsible parties in a timely, effective manner to expedite the billing and collection of accounts receivable

• Contributes to the steady reduction of the days-sales-outstanding (DSO), increase monthly gross collections and increase percentage of collections

• Ensures that "priority" work, which will enhance bottom line results and achievement of the most important objectives, is identified and assigned appropriately

• Partners with RCM QA and Training Specialist on quality assurance assessment results and feedback to ensure accuracy and productivity amongst the team

• Ensures approvals for adjustment requests are in line with protocol

• Initiates and participates in special accounts receivable and workflow and process improvement projects

• Prepares reports, presentations and other written communication

• Oversees denial prevention process by analyzing denial trends, prioritizing issues and identifying root cause

• Collaborates with stakeholders to update processes to prevent denials, and monitors and tracks progress

• Communicates to supervisor as needed regarding updates on account statuses

(30%) Staff Support

• Provides training, feedback, expertise and support to Insurance Denials Specialists

• Collaborates with team members to increase their knowledge of the collection process to effectively reduce accounts receivable

• Creates an environment that promotes team work and increases engagement

• Leads staff meetings and associate one-on-ones as needed

• Allocates specific job responsibilities/specialty tasks and defines priorities

• Initiates and participates in staff performance evaluations, development of associates including performance improvement plans and disciplinary actions

• Participates in the hiring and training of new associates

• Manages department and team schedule and hours

• Communicates to supervisor as needed regarding updates on account status'

(5%) Performs other duties as assigned

Required:

• High School diploma or equivalent

• 5+ years' experience in a medical billing department, prior authorization department or payer claim processing department

• Knowledge of Workers Compensation, HMO's, PPO's, MA and other third party payers

• Intermediate proficiency with Microsoft Excel, PowerPoint, Word and Outlook

Preferred:

• Associate's or Bachelor's degree

• Credentialed revenue cycle representative

• Previous supervisory experience