Lead Insurance Denials Specialist

RAYUS now offers DailyPay! Work today, get paid today!

The pay range for this position is $23.48 - $33.95 based on direct and relevant experience.

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 position is full-time 100% remote, working Monday - Friday, 8:00am - 5:00pm.

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:

• 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

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.