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 Insurance Specialist, you will be responsible for providing expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information and also serves as a resource to the team and other departments. This role develops and maintains positive relationships with referring physicians and patients and serves as a subject matter expert (SME) resource for the insurance team and other departments, taking ownership for process improvement, training and/or quality assurance, as assigned. The Lead Insurance Specialist ensures the team is consistently delivering the highest level of service. This position is full-time position working 8:30am - 5:00pm.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(55%) Insurance Administration

• 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
• Receives pre-authorization from patients and/or insurance companies and documents
• 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

Required:

• 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

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

RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible.

We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services! RAYUS Radiology is an EO Employer/Vets/Disabled.

We offer benefits (based on eligibility) including medical, dental and vision insurance, 401k with company match, life and disability insurance, tuition reimbursement, adoption assistance, pet insurance, PTO and holiday pay and many more! Visit our career page to see them all www.rayusradiology.com/careers.

*DailyPay implementation is contingent upon initial set-up period