Lead Insurance Denials Specialist for prior authorizations

RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for a Lead Insurance Denials Specialistto 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 ReceivableCollection&Leadership

• Communicateswith patients, carriers, co-workers,center staff,attorneys, and other contracted entities and responsible partiesin a timely, effective manner to expedite the billing and collection of accounts receivable
• Contributesto the steady reduction of the days-sales-outstanding (DSO), increase monthly gross collectionsand 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 accuracyand productivityamongst the team
• Ensures approvals for adjustment requests are in line with protocol
• Initiates and participates in special accounts receivable and workflowand process improvementprojects
• Preparesreports, presentations and other written communication
• Oversees denial prevention process by analyzing denial trends, prioritizing issues and identifying root cause
• Collaborates with stakeholders to updateprocesses to prevent denials, and monitors and tracks progress
• Communicates to supervisor as needed regarding updates on account statuses

(30%) Staff Support

• Providestraining, feedback, expertise andsupporttoInsurance DenialsSpecialists
• 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-onesas needed
• Allocates specific job responsibilities/specialty tasks and definespriorities
• Initiates and participates in staff performance evaluations, development of associates including performance improvement plans and disciplinary actions
• Participates inthe hiring and training of new associates
• Manages departmentand teamscheduleand hours
• Communicatesto supervisor as needed regarding updates on account status'

(5%) Performs other duties as assigned

Requirements:

Required:

• High School diploma or equivalent
• 5+years'experience in a medicalbilling 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 withMicrosoftExcel, PowerPoint, Word and Outlook

Preferred:

• Associate's or Bachelor's degree
• Credentialed revenue cycle representative
• Previous supervisory experience