Lead Insurance Specialist

RAYUS now offers DailyPay! Work today, get paid today!

RAYUS Radiology is looking for a Lead Insurance 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 Insuruance Specialist, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. Develops and maintains positive relationships with referring physicians and patients. Ensures the team is delivering the highest level of service.

This is a full-time position working days. 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(55%) Insurance Administration

• Prioritizes work load to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority
• Determines if patient's insurance is a part of the provider network
• Makes outgoing calls to insurance companies for pre-certification or any authorization
• Receives pre-authorization from patients and/or insurance companies and documents
• Contacts patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed
• Accurately enters a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system
• Maintains positive interactions with referring offices, patients and staff
• Backs up front desk reception and scheduling area as needed

(25%) Price Quotes

• Completes payor-related information i.e., payor, payor class, date of appointment
• Obtains all workers compensation approvals from insurance companies prior to scheduled exam
• Obtains signs and symptoms in order to support medical necessity

(15%) Team Supervision

• Manages the training and onboarding of new associates
• Assists in the recruiting, interviewing and hiring process for insurance specialists
• Leads regular staff meetings and associate one-on-ones
• Monitors and approves timecards
• Initiates and participates in staff performance evaluations, development of associates including performance improvement plans and disciplinary actions
• Assists in or establishes associate 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

(5%) Completes other duties as assigned

Required:

• High school diploma or equivalent
• 3+ years previous health care experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
• Prior experience with managed care and physician office scheduling
• Microsoft Office Suite Experience
• Proficient with using computer systems and typing

Preferred:

• Previous supervisory or leadership experience in an office environment
• Bilingual