- 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
- 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 team work 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 status'
- 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
- Associate's or Bachelor's degree
- Credentialed revenue cycle representative
- Previous supervisory experience
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Lead Insurance Denials Specialist for prior authorizations - St. Louis Park, United States - RAYUS Radiology
Description
RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, 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
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 provides direction and training to account representative team. Position is full-time, working remotely Monday - Friday 8:00am - 4:30pm
ESSENTIAL DUTIES AND RESPONBILITIES:
(65%) Accounts Receivable Collection & Leadership
(30%) Staff Support
(5%) Performs other duties as assigned
Required:
Preferred:
Rayus and its associates have an employment relationship, which is known as employment-at-will. This means that either Rayus or an associate has the right to terminate the employment relationship at any time, for any reason with or without cause or prior notice.
