[Hiring] Lead Insurance Denials Specialist @RAYUS Radiology

Role Description

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!

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

Essential Duties and Responsibilities:

• (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 teamwork 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 statuses.
• (5%) Performs other duties as assigned.

Qualifications

• 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.

Requirements

• 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.

Benefits

• Medical, dental and vision insurance.
• 401k with company match.
• Life and disability insurance.
• Tuition reimbursement.
• Adoption assistance.
• Pet insurance.
• PTO and holiday pay.
• Many more benefits (based on eligibility).

Company Description

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.