Lead Insurance Specialist

Job Summary RAYUS Radiology is looking for a Lead Insurance Specialist to join our team. The role focuses on insurance pre-certification and authorization, maintaining positive relationships with patients and referring physicians, acting as a subject matter expert for the insurance team, and supporting process improvement, training, and quality assurance. The Lead Insurance Specialist ensures the team consistently delivers high-level service. Essential Duties And Responsibilities Insurance Administration (55%) Prioritize workload to contact all patients before their exam, prioritizing those with highest payment responsibility. Determine whether a 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 it. Contact patient and referring offices using HIPAA guidelines when additional insurance info is needed. Accurately enter dates, schedule requests, patient names, referring physicians, and procedures into the computer system. Maintain positive interactions with referring offices, patients and staff. Back up the front desk reception and scheduling area as needed. Price Quotes (25%) Complete payor‑related information, including payor, payor class, and date of appointment. Obtain all workers’ compensation approvals from insurance companies prior to the scheduled exam. Collect patient signs and symptoms to support medical necessity. Team Supervision (15%) Manage the training and onboarding of new team members. Assist with recruiting, interviewing, and hiring of Insurance Specialists. Schedule and lead regular team meetings and one‑on‑one sessions. Monitor and approve timecards. Initiate and participate in performance evaluations, including improvement plans and disciplinary actions. Establish schedules to cover planned time off and ensure adequate Center coverage. Ensure comprehensive knowledge of company policies and procedures for the front office associate team. Completes Other Duties and Projects (5%) Perform other duties and projects as assigned. Other Information Remote Position: No Status: Full‑time (8:30 am – 5:00 pm) Requirements Required: High School Diploma or equivalent. Four (4) years of healthcare experience with various health insurance plans for pre‑certification and authorization of coverage. Three (3) years of experience with managed care and physician office scheduling. Two (2) years of demonstrated ability to serve as a resource and recognize process‑improvement opportunities. Advanced experience using Microsoft Office Suite. Proficient in using computer systems and typing. Preferred: Previous experience supervising or mentoring others in an office environment. Bilingual. Benefits RAYUS offers a comprehensive benefits package including medical, dental, and vision insurance; 401(k) with company match; life and disability insurance; tuition reimbursement; adoption assistance; pet insurance; paid time off and holiday pay. DailyPay implementation is contingent upon an initial set‑up period. EEO Statement RAYUS Radiology is an Equal Opportunity Employer. We are an EO Employer/Vets/Disabled. #J-18808-Ljbffr RAYUS Radiology