Insurance Supervisor
4 weeks ago
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.
- 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.
- Associate's Degree.
- Bilingual.
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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