Lead Insurance Denials Specialist

RAYUS Radiology•St. Louis Park, MN

1d•Remote

About The Position

RAYUS Radiology is seeking a Lead Insurance Denials Specialist to coordinate billing communications with patients, carriers, co-workers, attorneys, and other responsible parties to support timely accounts receivable collections. The role also provides direction, training, and support to the account representative team. This is a remote, full-time position with working hours of 8:00 a.m. to 4:30 p.m. The pay range is $27.49–$34.32, based on direct and relevant experience. The position supports customer service, collection performance, denial prevention, quality assurance, workflow improvement, and staff development. The lead analyzes denial trends and root causes, works with stakeholders to improve processes, and monitors progress. They also help prioritize work, prepare reports and presentations, support team members, and contribute to hiring, training, performance management, and team scheduling.

Requirements

High school diploma or equivalent.
At least 5 years of experience in a medical billing department, prior authorization department, or payer claim processing department.
Knowledge of Workers Compensation, HMOs, PPOs, 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 with AHIMA approval status.

Responsibilities

Communicate with patients, carriers, co-workers, center staff, attorneys, contracted entities, and other responsible parties in a timely and effective manner to expedite billing and collection of accounts receivable.
Contribute to reducing days sales outstanding, increasing monthly gross collections, and improving the percentage of collections.
Identify and appropriately assign priority work that supports financial results and key objectives.
Partner with the RCM QA and Training Specialist on quality assurance results and feedback to support team accuracy and productivity.
Ensure adjustment requests are approved in accordance with protocol.
Initiate and participate in accounts receivable, workflow, and process-improvement projects.
Prepare reports, presentations, and other written communications.
Oversee denial prevention by analyzing denial trends, prioritizing issues, identifying root causes, collaborating with stakeholders on process updates, and monitoring progress.
Provide training, feedback, expertise, and support to Insurance Denials Specialists.
Collaborate with team members to improve knowledge of the collection process and reduce accounts receivable.
Promote teamwork and engagement.
Lead staff meetings and associate one-on-ones as needed.
Allocate job responsibilities and specialty tasks, and define priorities.
Participate in staff performance evaluations, associate development, performance improvement plans, and disciplinary actions.
Participate in hiring and training new associates.
Manage department and team schedules and hours.
Communicate account-status updates to the supervisor as needed.
Perform other duties as assigned.