Insurance Denial Root Cause Specialist role

RAYUS now offers DailyPay! Work today, get paid today! The pay range for this position is $22.04-$31.87 based on direct and relevant experience. RAYUS Radiology is looking for a Revenue Process 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 Revenue Process Specialist, you will perform process quality analysis on revenue cycle management processes to optimize financial outcomes, increase efficiency and prevent errors that result in re-work. Collaborates with RCM Leadership and Market Operations on implementation of polices & procedures to drive consistency and improvement in overall revenue cycle operations. Provides support on transformational initiatives impacting RCM functions including process documentation, test preparation and execution, training & change management. Scope of processes to be analyzed including patient registration, scheduling, insurance, time-of-service collections, coding, billing, payment application, accounts receivable, claims & contract management. This is a full-time position working 40 hours per week; shifts are 8:00am - 5:00pm. ESSENTIAL DUTIES AND RESPONSIBILITIES: (35%) Revenue Cycle Process Analysis Collaborates with reporting & analytics team to obtain appropriate data for analysis, research and distribution Identifies trends and performs root cause analysis Collaborates with the Manager/Supervisor of the process owning team(s) to identify solutions in efforts to maximize productivity and minimize any financial impact Develops, researches, and writes new policies to support business initiatives Researches workflow, operational, and system impacts Manages approved policies and procedures through end-to-end lifecycle Analyzes recurring problems and formulates plans to address each, coordinating efforts with others as required (25%) Market Support & Communication Corresponds regularly with markets on education and assists with process improvement implementation for upstream processes (patient registration, coding, etc.), based on analysis Facilitates reoccurring continued education training sessions for the markets on revenue cycle related front office processes Assists in updating processes and procedures to maintain standards for patient registration, coding and appropriate documentation Delivers messages in a consistent format that provides markets visibility into trending issues impacting revenue, proposed improvements and identified outcomes Serves as primary point of contact for fielding market questions and requests regarding upstream processes (20%) Process Improvement Works with Process Improvement & Training Manager to identify process improvement opportunities Identifies the responsible working group of subject matter experts (SME) and collaborates with SME group to gather information, document current state business processes, and identify opportunities for improvement Works collaboratively with management and SMEs to understand desired performance and implement a future state process Participates in departmental quality improvement processes (15%) Training Conducts compliance training for new market acquisitions, new hires as needed, including by not limited to eligibility, patient estimations, time of service collections and end of day reconciliation Assesses learning needs and develops appropriate training solutions for new and existing processes; focusing on creating the best possible patient experience Conducts ongoing analysis of training effectiveness; updates tools and explores new materials for learners as needed Partners with Human Resources on the launch of new RCM related online trainings Monitors completion of RCM related online trainings, sending reminders to participants and providing management with status updates Takes action to stay abreast of current and evolving learning trends, instructional methods/techniques and emerging technologies. Identifies common trends and prepares and delivers system tips to end users (5%) Completes other tasks and projects as assigned 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! Required: High school diploma or equivalent 3 years' medical office and medical insurance policy experience Microsoft Office Suite experience Preferred: Bachelor's degree 1 year front office patient access services experience DailyPay implementation is contingent upon initial set-up period. #J-18808-Ljbffr