Lead, Insurance Claims Processing

PDS Health•Irving, TX

1d•$25 - $33

About The Position

Now is the time to join PDS Health. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gain valuable experience, apply today! The primary purpose and function of a Lead, Insurance Collections Specialist is to be responsible for assisting ROC Billing Supervisors by providing support with daily tasks and working collectively as a team with ROC team members.

Requirements

0-1+ years of professional experience
Equivalent to high school diploma or general education degree (GED)
EPIC knowledge
Ability to interpret EOB (Explanation of Benefits)
Ability to multi-task effectively without compromising the quality of the work.
Excellent interpersonal, oral, and written communication skills.
Detail oriented, organized, process focused, problem solver, proactive, ambitious, customer service focused.
Ability to draw conclusions and make independent decisions with limited information.
Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, and other members of the business community.
Self-motivated, reliable individual capable of working independently as well as part of a team.
Problem solving skills to gather & analyze information to identify and resolve problems in a timely manner.
Analytical skills to synthesize complex or diverse information.
Ability to research information and analyze data to arrive at valid conclusions, recommendations, and plans of action.
Actively share ideas in a constructive and positive manner by listening to and objectively considering ideas and suggestions from others.

Nice To Haves

Associate or Bachelor’s Degree or a one-year certificate from an accredited college or technical school; or equivalent combination of education and experience
Minimum of 6-month experience in medical or dental setting

Responsibilities

Will be responsible for training and complying with all duties assigned to the ROC Insurance Collection Specialist.
Lead team to maximize office collections, communicate issues, and implement ideas to improve processes.
Maintain and ensure that insurance carrier standards are up to date.
Share updated information from insurance carriers in the form of quick reference guides.
Assist ROC Billing Operation Supervisors in the development and training of team members.
Provide end of day/week reports to ROC Billing Operation Supervisors on team progress.
Lead daily office hours with the onshore team to support the development and training of team members.
Provide staff with assistance in performing difficult or complicated accounts.
Collaborate and share feedback with ROC Billing Operation Supervisors to increase team efficiency and communication.
Work with cross functional departments to research & resolve issues using innovative solutions.
Be able to complete assigned tasks and other duties assigned from ROC Billing Operation Supervisors.
Lead and participate in meetings and training sessions as required.
Provide auditors, billers, insurance collection specialists with assistance in the follow-up outstanding questions.
Ensures training and compliance modules are completed as needed for all new team members.
May be involved in assisting with work distribution for onshore and offshore team members.
Interact with other PDS departments and team members regarding certain operations. This includes but is not limited to plan credentialing, eligibility, fees, pre-authorizations, billing, auditing, claims follow-up, LT&D, Epic, IT, and Regional Analysts.
Maintains an appropriate professional appearance and demeanor in accordance with Company standards.
Other duties as assigned.