Lead Insurance Denials Specialist

RAYUS Radiology•St. Louis Park, MN

3d•$23 - $34•Onsite

About The Position

RAYUS Radiology is looking for a Lead Insurance Denials Specialist to join their team. This role challenges the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. 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 provide direction and training to the account representative team. This is a 100% Full-Time position working Monday through Friday, 8:00 am to 5:00 pm.

Requirements

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

Nice To Haves

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

Responsibilities

Communicate 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.
Contribute to the steady reduction of the days-sales-outstanding (DSO), increase monthly gross collections, and increase the percentage of collections.
Ensure that "priority" work, which will enhance bottom line results and achievement of the most important objectives, is identified and assigned appropriately.
Partner with RCM QA and Training Specialist on quality assurance assessment results and feedback to ensure accuracy and productivity amongst the team.
Ensure approvals for adjustment requests are in line with protocol.
Initiate and participate in special accounts receivable and workflow and process improvement projects.
Prepare reports, presentations, and other written communication.
Oversee denial prevention process by analyzing denial trends, prioritizing issues, and identifying root cause. Collaborate with stakeholders to update processes to prevent denials, and monitor and track progress.
Communicate to supervisor as needed regarding updates on account statuses.
Provide training, feedback, expertise, and support to Insurance Denials Specialists.
Collaborate with team members to increase their knowledge of the collection process to effectively reduce accounts receivable.
Create an environment that promotes teamwork and increases engagement.
Lead staff meetings and associate one-on-ones as needed.
Allocate specific job responsibilities/specialty tasks and define priorities.
Initiate and participate in staff performance evaluations, development of associates including performance improvement plans and disciplinary actions.
Participate in the hiring and training of new associates.
Manage department and team schedule and hours.
Perform other duties as assigned.