Lead Insurance Specialist

RAYUS Radiology•Woodbridge, VA

7h•Onsite

About The Position

RAYUS Radiology is looking for a Lead Insurance Specialist to join their team. This role provides expertise in insurance pre-certification and authorization of services by contacting insurance companies and patients to verify insurance information. The Lead Insurance Specialist serves as a resource to the team and other departments, develops and maintains positive relationships with referring physicians and patients, and acts as a subject matter expert (SME) for the insurance team. This role takes ownership for process improvement, training, and/or quality assurance, ensuring the team consistently delivers the highest level of service. This is a full-time position working 8:30 am - 5:00 pm.

Requirements

High School Diploma, or equivalent
Four (4) years' healthcare experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
Three (3) years' experience working with managed care and physician office scheduling
Two (2) years' demonstrated ability to serve as a resource to others and recognize process improvement opportunities
Advanced experience using Microsoft Office Suite products
Proficient with using computer systems and typing

Nice To Haves

Previous experience supervising or leading/mentoring others in an office environment
Bilingual

Responsibilities

Prioritize workload to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority.
Determine if patient's insurance is a part of the provider network.
Make outgoing calls to insurance companies for pre-certification or any authorization.
Receive pre-authorization from patients and/or insurance companies and document.
Contact patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed.
Accurately enter a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system.
Maintain positive interactions with referring offices, patients and staff.
Backup front desk reception and scheduling area as needed.
Complete payor-related information, i.e., payor, payor class, date of appointment.
Obtain all workers compensation approvals from insurance companies prior to scheduled exam.
Obtain patient signs and symptoms in order to support medical necessity.
Manages the training and onboarding of new team members.
Assist with the recruiting, interviewing and hiring process for Insurance Specialists.
Schedule and lead regular team meetings and team member one-on-ones.
Monitor and approve timecards.
Initiate and participate in team member performance evaluations and development, including performance improvement plans and disciplinary actions.
Assist in or establishes team member schedules to provide for planned time off, ensuring appropriate staffing levels and adequate Center coverage.
Ensures comprehensive knowledge of company policies and procedures for front office associate team.
Completes Other Duties and Projects as Assigned.