Lead Insurance Denials Specialist

RAYUS Radiology 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. This is a remote Full-Time position working 8:00am-4:30pm.

ESSENTIAL DUTIES AND RESPONBILITIES:

Fosters an environment where customer service is a priority by believing in and practicing The Experience

(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

• 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:

• Bachelor's degree strongly preferred
• Credentialed revenue cycle representative
• Previous supervisory experience
• Completion of a coding certificate program in a program with AHIMA approval status