Auto & Personal Injury Specialist

RAYUS Radiology is looking for an Accounts Receivable (A/R), Auto & Personal Injury 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 Accounts Receivable (A/R), Auto & Personal Injury Specialist, you will be responsible for investigating, managing, and resolving outstanding medical accounts receivable associated with automobile accidents, personal injury claims, and third-party liability cases. This role identifies the appropriate reimbursement sources, resolves billing and payment discrepancies, coordinates with insurance carriers and legal representatives, and pursues timely collection of outstanding balances. The Accounts Receivable (A/R), Auto & Personal Injury Specialist requires knowledge of automobile insurance coverage, Personal Injury Protection (PIP), Medical Payments (Med Pay), liability claims, and personal injury reimbursement processes. The specialist must demonstrate strong analytical skills, independent problem-solving, and effective account management to maximize reimbursement and reduce aged accounts receivable. This is a remote US based only position working Monday - Friday, full time working 40 hours per week working corporate hours.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(85%) Auto Insurance Claims

1. Verify automobile insurance claim information, including claim numbers, dates of loss, assigned adjusters, coverage status, and available benefits.
2. Review, investigate, and resolve unpaid, denied, underpaid, and delayed claims through appropriate follow-up with insurance carriers, claims adjusters, attorneys, and other responsible parties.
3. Apply state-level knowledge of PIP, Med Pay, no-fault insurance, and liability coverage requirements to research payment determinations, benefit limitations, and reimbursement options.
4. Identify and resolve billing discrepancies, claim submission errors, and documentation deficiencies that prevent reimbursement.
5. Coordinate with attorneys, law firms, and other authorized representatives to obtain case status updates, verify outstanding balances, and pursue payment on accounts associated with litigation or settlements.
6. Validate, pursue, and maintain accident-related documentation, including Letters of Protection, medical liens, and settlement correspondence, as applicable.
7. Monitor accounts pending litigation outcomes, settlement distributions, or third-party reimbursement to ensure timely follow-up and collection.
8. Review settlement or balance-reduction requests, escalating them for approval in accordance with organizational policies and established authority levels.
9. Investigate alternative reimbursement sources when accident-related coverage is unavailable, exhausted, or determined not responsible, in accordance with applicable billing requirements.
10. Maintain accurate, timely documentation of account activity, communications, and resolution efforts, and collaborate with internal departments to resolve complex accounts.
11. Meet established productivity, quality assurance, and overall performance expectations.
12. Maintain compliance with applicable federal and state regulations, HIPAA requirements, and organizational policies.

1. Coordinate and collaborate with other AR teams and RCM departments regarding appropriate billing of medical insurance based on state laws and the type of coverage available.
2. Determine the correct billing order between auto and health coverage based on state law and coverage type.
3. Apply state auto insurance laws and Letter of Protection (LOP - an agreement whereby a provider treats an injured patient and agrees to defer collection until the personal injury claim resolves) terms to guide billing and collection efforts.

1. High school diploma, or equivalent
2. Bachelor's degree in healthcare administration, business, or other related and applicable field; may consider the equivalent in a combination of education and work experience in lieu of degree
3. Two (2) years' experience in healthcare accounts receivable, medical billing, automobile or personal injury claims processing, insurance collections, denial management, or a combination thereof
4. Experience researching and resolving complex billing and insurance claim discrepancies
5. Strong verbal, written, and electronic communication skills with the ability to interact professionally with internal and external stakeholders.
   Proficiency in Microsoft Windows and Office Suite; Outlook, Teams, Excel, Word, PowerPoint, etc..
6. Valid driver's license and proof of current insurance is required for the team member to personally drive a vehicle for company business (regardless of whether it's a company or personal vehicle)

Preferred:

1. Bachelor's degree in in healthcare administration, business, or other related and applicable field
2. Experience in automobile, personal injury, or third-party liability medical accounts receivable.
3. Knowledge of Personal Injury Protection (PIP), Medical Payments (Med Pay), no-fault insurance, medical liens, and settlement processes.
4. Knowledge of medical record requirements, Release of Information (ROI) regulations, and authorization procedures associated with personal injury and liability claims

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.