Insurance Supervisor

4 weeks ago


Boynton Beach, Florida, United States RAYUS Radiology Full time
Job Summary

We are seeking an experienced Insurance Supervisor to join our team at RAYUS Radiology. The successful candidate will be responsible for providing expertise in insurance pre-certification and authorization of services, developing and maintaining positive relationships with referring physicians and patients, and ensuring the team delivers the highest level of service.

Key Responsibilities
  • Insurance Administration (35%):
    • Prioritize workload to ensure all patients are authorized prior to their exam.
    • Determine if patient's insurance is part of the provider network.
    • Make outgoing calls to insurance companies for pre-certification or 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 into the computer system.
    • Maintain positive interactions with referring offices, patients, and staff.
    • Obtain signs and symptoms to support medical necessity.
    • Obtain all workers' compensation approvals from insurance companies prior to scheduled exam.
    • Complete payor-related information.
  • Team Management (35%):
    • Support associates to ensure the highest level of patient satisfaction.
    • Ensure comprehensive knowledge of the company's policies and procedures for all associates.
    • Establish associate schedules to provide for planned time off and ensure adequate center coverage.
    • Monitor and approve timecards.
    • Participate in staff planning and hiring process.
    • Initiate and participate in associate performance evaluations, compensation, and development.
    • Lead regular staff meetings and associate one-on-ones.
    • Develop and monitor the team's performance through QA process.
    • Implement training program for new associates.
    • Foster a team environment and ensure appropriate communication between departments.
    • Create and update center information manuals as needed.
  • Price Quotes (25%):
    • Verify insurance eligibility and benefits.
    • Calculate patients' expected financial responsibility.
    • Notify patients of expected financial responsibility.
  • Other Duties (5%):
    • Complete other duties as assigned.
Requirements
  • High school diploma or equivalent.
  • 4+ years of previous healthcare experience working with various 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 tasks under pressure.
Preferred Qualifications
  • Associate's Degree.
  • Bilingual.
Working Conditions

The successful candidate will require the use of office equipment, such as computers, fax machines, telephones, and copiers. They will also require talking on the telephone and computer-related activities for extended periods. The ability to see, hear, speak, write, and key is also necessary. Some lifting, bending, and stooping may be required.


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