Insurance Supervisor

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RAYUS Radiology is looking for an Insurance Supervisor 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!

JOB SUMMARY: Provides 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 position is full-time Monday-Friday, 8:30am - 5:00pm.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(35%) Insurance Administration

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

(35%) Team Management

• Supports associates ensuring highest level of patient satisfaction
• Ensures comprehensive knowledge of the company's policies and procedures for all associates
• Establishes associate schedules to provide for planned time off, ensuring appropriate staffing levels and adequate center coverage
• Monitors and approves timecards
• Participates in staff planning and hiring process along with management
• Initiates and participates in associate performance evaluations, compensation and development of associates including performance improvement plans, disciplinary actions and/or terminations
• Leads regular staff meetings and associate one-on-ones
• Develops and monitors the teams' performance through QA process
• Implements training program for new associates
• Fosters a team environment, ensuring appropriate communication between departments
• Creates and updates center's information manuals as needed

(25%) Price Quotes

• Verifies insurance eligibility and benefits
• Calculate patients expected financial responsibility
• Notify patients of expected financial responsibility

(5%) Completes other duties as assigned

SUMMARY OF QUALIFICATIONS:

• High school diploma or equivalent
• 4+ years previous health care experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage
• Prior supervisory or leadership experience in an office environment
• Prior experience with managed care and physician office scheduling
• Proficient with using computer systems and typing
• Knowledge of medical terminology
• Knowledge of CPT and ICD-10 coding
• Ability to read and interpret physician notes, diagnosis and other clinical documentation
• Ability to multitask
• Ability to focus and maintain direction in the tasks at hand under pressure
• All remote workers may be required to work in the office intermittently

• Associate's Degree
• Bilingual

WORKING CONDITIONS:

• Requires the use of office equipment, such as computers, fax machines, telephones and copiers
• Requires talking on the telephone and computer related activities for extended periods of time
• Requires the ability to see, hear, speak, write and key
• Requires the ability to do data entry for periods of 30-45 minutes per hour
• May have exposure to respiratory secretions (such as coughing, TB, etc.), blood, and/or other bodily fluids via patient contact
• May require some lifting, bending and stooping

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.